An education campaign to reduce children’s unsupervised exposure to drugs builds on existing efforts to limit misuse of pediatric OTCs.

The Consumer Healthcare Products Association worked with the Centers for Disease Control and Prevention as part of a public-private safe-medication initiative on the “Up and Away and Out of Sight” campaign to educate caregivers about how to stop curious children from finding and consuming drugs without supervision.

The multimedia campaign, officially launched Dec. 13, includes a print public service announcement in the Dec. 25 Parade magazine, an online video message, a pamphlet on enforcement and a poster for doctors’ offices, said Emily Skor, VP of communications and alliance development at CHPA. The campaign also will offer a tip sheet to remind caregivers how to store medicines safely, teach children about medicine safety and what to do in an emergency.

Skor explained 60,000 children are taken to hospital emergency rooms annually after finding and taking medicine without adult supervision, and one of the campaign’s main goals is to reduce that number.

Up, Away And Out Of Sight Messages

The “Up and Away and Out of Sight” campaign focuses on reducing unsupervised pediatric self-exposure to drugs. The campaign’s key messages include:

Store medicines and vitamins out of children’s reach
Put medicines away every time
Hear the click to ensure the safety cap is locked
Teach children about medicine safety
Tell guests about medicine safety
Be prepared in case of emergency by programming the poison control center in phones

“This campaign is all inclusive and not specific to any medicine or vitamin. Young children are not discerning if they see a bottle on the counter,” can reach it and consume it, which is why the campaign tells consumers to keep all medicines out of reach and sight of children, Skor said.

Self-Exposure “Is Getting Worse, Not Better”

The campaign also addresses concerns raised in Cincinnati Children’s Hospital Medical Center researchers’ recent study that found the number of accidental overdoses in children 5 years and younger increased 20% from 2001 to 2008 compared to the previous 10 years.

A review of patient records from the National Poison Data System of the American Association of Poison Control Centers of children 5 years and younger in the eight-year period revealed “the problem of pediatric medication poisoning is getting worse, not better,” according to the study in The Journal of Pediatrics in September 2011.

The researchers found the vast majority – 95% – of pediatric accidental overdoses that led to emergency department visits were due to child self-exposure, and 55% of those visits were due to self-exposure of prescription drugs. The remaining 5% of visits were due to therapeutic error.

“The mostly likely explanation for these observations is a rise in the number of medications in the environment of small children,” the researchers hypothesize.

They note 50% of adults surveyed in 1998-1999 said they took at least one prescription in the preceding week and 7% took at least five. In 2006 the percentage climbed to 55% taking one prescription in the previous week and 11% taking at least five.

The researchers also note a 24% rise in the number of visits by children following ingestion of OTC medications – with 59% of those cases linked to acetaminophen – without a change in the admission or injury rate. They say the most likely explanation is more medication is available or in homes, or less prevention is practiced.

The increase in use and prevalence of Rx drugs in homes with children may be due to the rising incidence of obesity and metabolic syndrome in younger adults, and the increase in prescriptions for attention-deficit/hyperactivity disorders. Likewise, they add, the use of OTC acetaminophen climbed 28% from 2004 to 2008, which might translate to more availability in homes.

Notably, therapeutic errors with OTC acetaminophen and cough/cold medications did not contribute significantly to emergency department visits – accounting for just 1.2% of visits, according to the study. The rate of injuries associated with therapeutic dosing errors of OTC cough/cold medicines fell 36%, the study notes.

The safety of these products has been the focus of much media and FDA scrutiny in the last few years, and the low percentages of therapeutic errors could reflect industry and government efforts to educate caregivers about the safe use and appropriate dosing of these products.

CHPA in 2007 launched a campaign to promote safe use of OTC cough/cold products and continues to provide free downloadable information to help patients safely and effectively administer pediatric OTCs at OTCsafety.org Also see "CHPA Rolls Out Pediatric Cough/Cold Education Campaign" - Pink Sheet, 5 November, 2007..

The trade group during the previous cold season also ran a print and online ad campaign in Parade publications that featured a picture of a cluttered kitchen with a bottle of medicine by the sink. The ad asked if readers “can spot the medicine before your 2-year-old does,” and advised caregivers to “keep your kids safe by keeping medicines safely out of their reach and sight.”

While this ad campaign pre-dated the official launch of the “Up and Away and Out of Sight” campaign, it shares the same safety message, Skor said. She explained that CHPA ran the ad before the launch because a public service announcement opportunity arose and the group did not want to pass up a chance to educate caregivers.

PROTECT’s Broader Goals

The current campaign is the brainchild of the Preventing Overdose and Treatment Errors in Children Task Force, which includes CDC, CHPA and others, and is just one of many components of the PROTECT Initiative. The PROTECT Initiative was created to examine and address medication dosing errors in children.

The PROTECT Initiative also spearheaded innovative packaging changes to limit the amount of medication children can ingest, even if a child-resistant cap was not properly replaced Also see "Child-Resistant Packaging In The Works For More OTC Cold Products – CHPA" - Pink Sheet, 4 February, 2008.

Several OTC drug makers committed to incorporating packaging changes for pediatric liquids before the end of this year. Among them is Johnson & Johnson’s McNeil Consumer Healthcare, which promised Infant’s Tylenol would come in a new bottle with a protective flow restrictor opening and push-syringe designed to increase dosing accuracy, reduce spills and reduce the risk of children accessing the medicine. McNeil also previously launched single-serving pre-filled spoons for Perfect Measure versions of its Zyrtec and Benadryl allergy relievers. In 2009,Wyeth Consumer Healthcare– now part ofPfizer Inc.– launched similarly packaged versions of Robitussin To Go cough and cold medicine.

PROTECT also developed a voluntary guideline for standardizing and clarifying dosing measures for OTC liquid medicines, which closely aligns with FDA guidance on liquid OTC products issued in May. Unlike the current campaign, the guideline was aimed at unintentional therapeutic doses Also see "OTC Industry Standardizes Pediatric Liquid Acetaminophen Concentration" - Pink Sheet, 9 May, 2011..

Standardizing liquid dosing measures also addressed unintentional therapeutic misdosing and misuse of OTCs, which is a broader message CHPA and others have delivered in other educational efforts. For example, CHPA’s “Know Your Dose” campaign focused on teaching consumers about the risks and benefits of acetaminophen and how to safely use the drug without overdosing Also see "Acetaminophen Awareness Coalition Prepares To Launch Education Campaign" - Pink Sheet, 22 November, 2010..

Campaign Targets Unsupervised Pediatric Drug Ingestion

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