Patterns of pharmaceutical poisoning teleconsultations in Saudi Arabia: a retrospective study of community-based toxicity calls through the national toxicology consultation services.

Abstract

Introduction: Pharmaceutical-related toxic exposures represent a significant global health concern. This study analyzed teleconsultation data from the national Toxicology Consultation Services hotline to understand patterns of teleconsultations for pharmaceutical toxicity cases, demographic characteristics, and management dispositions.

Methods: This nationwide cross-sectional study conducted in Saudi Arabia analyzed medication-related toxicity cases reported through public calls to the national toxicology hotline in 2023. Data were analyzed for demographic patterns, therapeutic medication classifications, clinical presentations, and management decisions made by Specialist in Poison Information providers.

Results: Of 19,317 teleconsultations analyzed in 2023, children younger than five years accounted for 61.4% (n = 11,864) of cases, with toddlers (<3 years old) demonstrating the highest population-adjusted consultation rate (68.47 per 10,000). Females had higher population-adjusted consultation rates than males (7.85 versus 4.83 per 10,000, P <0.001). Analgesics and anti-inflammatory agents were the most frequently implicated medications (30.4%, n = 5,871), predominating in pediatric exposures (up to 45.5%, n = 378 in infants), whereas cardiovascular agents were most common among the elderly (46%, n = 312). Age was significantly associated with medication category (chi-square test, P <0.001). Most patients were asymptomatic (97.4%, n = 18,821), and home observation was recommended for 71.1% (n = 13,741) of cases. Medication class was significantly associated with management disposition (P <0.001) Respiratory and cardiovascular agents had the highest hospital referral rates (49.6%, n = 514 and 48.5%, n = 724, respectively). Geographic variation was minimal, indicating nationally consistent patterns.

Discussion: This nationwide analysis demonstrates distinct age-related medication toxicity patterns and highlights the role of centralized toxicology teleconsultation services in providing nationwide specialized care. The high proportion of asymptomatic cases managed through home observation likely reflects the service's capacity to optimize healthcare resource utilization while maintaining patient safety.

Conclusion: These findings identify specific demographic groups to prioritize for poisoning-prevention strategies and characterize how a centralized teleconsultation service triages pharmaceutical exposures. Future studies linking teleconsultation advice to verified clinical outcomes are recommended to determine its effect on resource utilization and patient safety.