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MPS-5.3 Data Details

MPS-5.3 Reduce emergency department (ED) visits for overdoses from narrow-therapeutic-index medications

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance Project (NEISS-CADES); Centers for Disease Control and Prevention and Consumer Product Safety Commission and Food and Drug Administration (CDC and CPSC and FDA)
National Hospital Ambulatory Medical Care Survey (NHAMCS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
National Ambulatory Medical Care Survey (NAMCS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 10,000 outpatient prescription visits 
Baseline (Year)
8.9 (2006-2007)
Target
8.0
Target-Setting Method
10 percent improvement
Numerator
Estimated number of ED visits for overdoses from narrow-therapeutic-index medications (digoxin, phenytoin, carbemazepine, divalproex, lithium)
Denominator
Estimated number of outpatient prescription visits at which narrow-therapeutic-index medications (digoxin, phenytoin, carbemazepine, divalproex, lithium) were prescribed
Data Collection Frequency
Biennial
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Measuring national rates of emergency department (ED) visits for adverse events from medications requires using two data sources. Stable annual national estimates of ED visits for adverse events due to specific medications may be calculated using NEISS-CADES, but NEISS-CADES does not collect prescribing data. N(H)AMCS data can be used to calculate national estimates of medication prescribing, but N(H)AMCS data are not robust enough to calculate stable annual estimates of ED visits for adverse events to specific medications.

To calculate the numerator: The cause/mechanism of each adverse drug event visit is coded as allergic reaction, side-effect or overdose. Only ED visits due to overdoses are included in the numerator. In addition, up to two drugs may be implicated in the adverse event. If a narrow-therapeutic-index medication (digoxin, phenytoin, carbemazepine, divalproex, lithium) appears as an implicated drug, the associated ED visit is included in the numerator. To calculate the denominator: Up to eight drugs may be identified as prescribed or continued during the outpatient visit. If a narrow-therapeutic-index medication (digoxin, phenytoin, carbemazepine, divalproex, lithium) appears as a prescribed or continued drug, the associated outpatient visit is included in the denominator.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

The original baseline was revised from 9.2 to 8.9 due to a change in the baseline year from 2007 to 2006-2007. The target was adjusted from 8.3 to 8.0 to reflect the revised baseline using the original target-setting method.

References

Additional resources about the objective.

  1. Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. JAMA 2006;296:1858-66.
  2. Budnitz DS, Shehab N, Kegler SR, Richards CL. Emergency department visits for adverse drug events in older adults: the contribution of potentially inappropriate medication use. Ann Intern Med 2007;147:755-765.
  3. Jhung MA, Budnitz DS, Mendelsohn AB, Weidenbach KN, Nelson TD, Pollock DA. Evaluation and overview of the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project (NEISS-CADES). Medical Care 2007;45 (suppl 2):S96-S102.