Exploring medicine exposure in whānau Māori reported to the Aotearoa New Zealand National Poisons Centre

Purpose

The Aotearoa New Zealand National Poisons Centre (NPC) advises the public and health professionals on the management of any substance exposure (poisoning), including exposure to medicines occurring in unintended ways, such as overdose or administration to the wrong patient. This study aimed to i) identify the top five medicines most frequently resulting in exposure reported to the NPC in whānau Māori (Māori extended families); ii) identify the reasons for exposure to medicines in whānau Māori in contact with the NPC and the sites of exposure incidents; and iii) characterise the advice provided by the NPC in these cases.

Methods

This retrospective study used de-identified data from contact with the NPC during 2019–23 where the patients were of Māori ethnicity, to identify the medicines most frequently resulting in exposure in Māori kaumātua (age 65 years and over), pakeke (age 20 to 64 years), rangatahi Māori (age 13 to 19 years) and tamariki Māori (age 0 to 12 years). The sites where these exposures occurred, the reasons for exposures, and advice provided by NPC were characterised.

Main findings

The NPC provided advice in 7,493 records of patients who identified as Māori ethnicity and who had been exposed to at least one medicine. Paracetamol and ibuprofen were the most frequently reported medicines in all age groups except kaumātua, whose exposure most frequently involved metoprolol, acetylsalicylic acid and paracetamol. A clear majority of records were due to unintentional exposure (3,967; 53%) or therapeutic error (2,057; 27%), occurring amongst tamariki Māori (4,686; 63%), in residential settings (7,141; 95%), and being advised to manage at home or that no treatment was needed (5,317; 71%). Intentional exposure increased in rangatahi Māori over the study period (from 0.4 to 1.3 records/1,000 person-years).

Principal conclusion

Given the numbers of whānau Māori using the NPC services, there is a need for systematic support for whānau about the potential harm of medicines and how to safely manage medication. This study highlights the importance of safe storage of medicines at home to prevent tamariki Māori and rangatahi Māori from gaining unsafe access. Future research needs to explore ways of whānau Māori-led solutions for safer medicine storage and to explore solutions to reduce intentional exposure, especially in rangatahi Māori, and reasons why this may be increasing over time.