Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures

Introduction: Emergency department visits and hospitalizations for unsupervised medication expo-sures among young children increased in the early 2000s. Prevention efforts were initiated in response.Methods: Nationally representative data from the National Electronic Injury Surveillance System -Cooperative Adverse Drug Event Surveillance project collected from 2009 to 2020 were analyzed in 2022 to assess overall and medication-specific trends in emergency department visits for unsu-pervised exposures among children aged <= 5 years.Results: From 2009 to 2020, there were an estimated 677,968 (95% CI=550,089, 805,846) emer-gency department visits for unsupervised medication exposures among children aged <= 5 years in the U.S. Most visits involved children aged 1-2 years (2009-2012 [70.3%], 2017-2020 [67.4%]), and nearly one half involved prescription solid medications (2009-2012 [49.4%], 2017-2020 [48.1%]). The largest declines in estimated numbers of annual visits from 2009-2012 to 2017-2020 were for exposures involving prescription solid benzodiazepines (-2,636 visits,-72.0%) and opioids (-2,596 visits,-53.6%) and over-the-counter liquid cough and cold medications (-1,954 visits, -71.6%) and acetaminophen (-1,418 visits,-53.4%). The estimated number of annual visits increased for exposures involving over-the-counter solid herbal/alternative remedies (+1,028 visits, +65.6%), with the largest increase for melatonin exposures (+1,440 visits, +421.1%). Overall, the estimated number of visits for unsupervised medication exposures decreased from 66,416 in 2009 to 36,564 in 2020 (annual percentage change=-6.0%). Emergent hospitalizations for unsuper-vised exposures also declined (annual percentage change=-4.5%). Conclusions: Declines in estimated emergency department visits and hospitalizations for unsuper-vised medication exposures from 2009 to 2020 coincided with renewed prevention efforts. Targeted approaches may be needed to achieve continued declines in unsupervised medication exposures among young children.