Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Pharmacoepidemiol Drug Saf. 2022 Feb;31(2):225-234. doi: 10.1002/pds.5384. Epub 2021 Nov 24.
Characterization of emergency department (ED) visits for acute harms related to use of over-the-counter cough and cold medications (CCMs) by patient demographics, intent of CCM use, concurrent substance use, and clinical manifestations can help guide prevention of medication harms.
Public health surveillance data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project were used to estimate numbers and population rates of ED visits from 2017 to 2019.
Based on 1396 surveillance cases, there were an estimated 26 735 (95% CI, 21 679-31 791) US ED visits for CCM-related harms annually, accounting for 1.3% (95% CI, 1.2-1.5%) of all ED visits for medication adverse events. Three fifths (61.4%, 95% CI, 55.6-67.2%) of these visits were attributed to non-therapeutic CCM use (nonmedical use, self-harm, unsupervised pediatric exposures). Most visits by children aged <4 years (74.0%, 95% CI, 59.7-88.3%) were for unsupervised CCM exposures. Proportion hospitalized was higher for visits for self-harm (76.5%, 95% CI, 68.9-84.2%) than for visits for nonmedical use (30.3%, 95% CI, 21.1-39.6%) and therapeutic use (8.8%, 95% CI, 5.9-11.8%). Overall, estimated population rates of ED visits for CCM-related harms were higher for patients aged 12-34 years (16.5 per 100 000, 95% CI, 13.0-20.0) compared with patients aged <12 years (5.1 per 100 000, 95% CI, 3.6-6.5) and ≥ 35 years (4.3 per 100 000, 95% CI, 3.4-5.1). Concurrent use of other medications, illicit drugs, or alcohol was frequent in ED visits for nonmedical use (61.3%) and self-harm (75.9%).
Continued national surveillance of CCM-related harms can assess progress toward safer use.
通过患者人口统计学特征、使用非处方咳嗽和感冒药物（CCM）的意图、同时使用其他物质和临床表现来描述与使用 CCM 相关的急症的急诊科就诊情况，有助于指导预防药物伤害。
利用国家电子伤害监测系统合作药物不良事件监测项目的公共卫生监测数据，估计 2017 年至 2019 年每年因 CCM 相关伤害而到急诊科就诊的人数和人口比例。
基于 1396 例监测病例，每年约有 26735 例（95%可信区间为 21679-31791 例）因 CCM 相关伤害而到美国急诊科就诊，占所有因药物不良事件而到急诊科就诊的 1.3%（95%可信区间为 1.2-1.5%）。这些就诊的五分之三（61.4%，95%可信区间为 55.6-67.2%）归因于非治疗性 CCM 使用（非医疗使用、自我伤害、儿童无监督暴露）。4 岁以下儿童的就诊比例（74.0%，95%可信区间为 59.7-88.3%）均为儿童无监督 CCM 暴露。自我伤害就诊者的住院比例（76.5%，95%可信区间为 68.9-84.2%）高于非医疗使用就诊者（30.3%，95%可信区间为 21.1-39.6%）和治疗性使用就诊者（8.8%，95%可信区间为 5.9-11.8%）。总体而言，年龄在 12-34 岁的患者因 CCM 相关伤害而到急诊科就诊的估计人口比例（每 10 万人中有 16.5 人，95%可信区间为 13.0-20.0）高于年龄在 12 岁以下的患者（每 10 万人中有 5.1 人，95%可信区间为 3.6-6.5）和年龄在 35 岁以上的患者（每 10 万人中有 4.3 人，95%可信区间为 3.4-5.1）。非医疗使用（61.3%）和自我伤害（75.9%）就诊者同时使用其他药物、非法药物或酒精的情况较为常见。
继续对 CCM 相关伤害进行全国性监测，可以评估在更安全使用方面的进展。
