Adherence of caregivers of children to advice provided by a National Poison Information Center

Abstract

Introduction

Most calls to poison information centers are from the public, pertaining to young children, and due to minor or nontoxic exposures. Rational poison center consultations can prevent unnecessary visits to emergency departments (EDs), callers’ adherence to such advice is required.

Objectives

Estimate adherence of callers from the public to the poison center concerning exposures of young children to the advice provided by the clinical toxicologist, estimate the number of unnecessary ED visits of these children prevented by poison center consultations.

Methods

Prospective, phone-survey cohort study. Calls from the public concerning children under 6 years old were recorded and collected, telephone follow-up was performed within two weeks. Data collected included: demographics, exposure, severity, triage advised, adherence to the advice, reasons for nonadherence, and what the caller would have done had the poison center been unavailable. The study was conducted over 3 months representing different seasons and holidays times during a 1-year period.

Results

1762 callers completed the telephone follow-up; 1443 (81.9%) cases were asymptomatic at the time of call; 1452 (82.3%) were advised to remain at home, 175 (9.9%) and 137 (7.8%) were referred to community clinics and EDs, respectively; 1648 (93.5%) of callers adhered to the advice provided; highest adherence rate was among callers advised to stay home (98.3%, 1427), and 78.9% (108) and 62.1% (109) among callers referred to EDs and community clinics, respectively. Among callers advised to stay home, 491 stated that they would have referred themselves to the ED had the poison center been unavailable, an annual estimate of 4309 cases. The main parameter predicting nonadherence was calls made during night shift.

Conclusions

The high adherence of callers to the poison center consultation suggests it plays an important role in preventing unnecessary ED visits of young children due to poison exposures, and may substantially reduce ED load and costs.

Keywords:

• Adherence
• compliance
• consultation
• poisoning
• poison center

Acknowledgment

The authors thank Mrs. Ronit Leiba, Department of Clinical Epidemiology, Rambam Health Care Campus, for her assistance in performing the statistical analyses, and Mrs. Vered Steiner and Ms. Gali Soryano for their most valuable secretarial assistance.

Presentation

The study was presented in part in the 39th Annual Congress of the European Association of Poison Control Centres and Clinical Toxicologists, Naples, Italy, May 21-24, 2019.

Disclosure statement

No potential conflict of interest was reported by the author(s).