A study of knowledge, attitude and practice regarding administration of pediatric dosage forms and allied health literacy of caregivers for children

Abstract

Context:Caregivers of sick children have to be careful with medicine dosing and giving medicines to a reluctant child can be challenging.Aim:To assess the knowledge, attitude, and practices of caregivers regarding pediatric medicine administration and health literacy allied to this task.Settings and Design:This cross-sectional study was carried out on outpatient and inpatient basis in the pediatrics department of a teaching hospital over 6 months.Subjects and Methods:Data regarding sociodemographic profile of patient and caregiver, idea regarding pediatric dosage forms, dosing of medicines, and medication errors during administration were recorded from 377 caregivers. Reconstitution of dry powder and measurement of 5 mL liquid medicine using measuring cup of the medicine phial was demonstrated by the caregivers.Statistical Analysis:Association assessed by point biserial correlation and Spearman's rank correlation.Results:Majority of the primary caregivers surveyed were young, educated, homemaker mothers. Liquid medicines were used maximally (88.9%). Majority (87.3%) of the caregivers used standardized dosing instruments to measure liquids and reconstitution (85.9%), and teaspoon measurement task (91%) was performed satisfactorily by most. Some potentially wrong practices (e.g., adding medicine to milk, redilution of reconstituted medicine, and storing beyond the recommended period) were recorded. Medication errors were reported by 44.5% caregivers, significantly more in the outpatient setting. Although the statistical correlation was weak, the chance of medication error was less, and the precision of measurement was better with increasing education of the caregiver.Conclusions:Physicians need to be aware of the limitations of knowledge and the possibility of wrong administration practices among caregivers of children. Remedial measures in this regard can reduce the risk of medication errors.

Literature review of medication administration problems in paediatrics by parent/caregiver and the role of health literacy

“… 3 4 The inability to administer medication correctly may result in adverse drug events and poor patient clinical outcomes. 5 Causes of medication administration problems at home are multifactorial and potentially depend on various factors. 2 So, in order to improve medication administration by parents and patients, an initial assessment of the current problems and factors that may contribute to this issue must be identified first.…”

Medication-related Knowledge, Administration Practice and Adherence Among Caregivers of Chronically Ill Children in Malaysia

“…Only caregivers who are able to handle the medications correctly at home can shield their children from undesirable adverse events [5]. While dosing errors are common with liquid formulations [7,8,26], it is found that most caregivers in this study were able to perform the measurement according to the instructions.…”

“…This suggests that health care providers have been providing them with su cient medication-related information, as highly recommended in the existing guidelines [23,24]. In contrast with caregivers from other developing countries who still tended to use a household spoon for medication administration [7,9], all participants in this study managed to measure the medication correctly by using a proper measuring device. However, unlike other countries [18,25], caregivers in Malaysia were commonly not familiarized with the generic names of medications [23,24].…”

“…However, insu cient knowledge of medications in caregivers has been resulting in countless adverse drug events in children. Their di culty in reading drug labels, poor understanding of medication instructions, confusion about different brand names of drugs, unfamiliarity with the devices to be used for medication administration and poor communication with their partners in child care are all known factors contributing to medication errors in children [5,7,8]. Thus, education about the medications in caregivers of young children is essential [6,7].…”

“…While liquid formulation remains the most common form of dosage form for young children, Caregivers, especially those from the developing countries, have di culties in liquid measurement [5,7,9]. Thus, dosing errors in children is more prevalent than in adults, and such errors could cause harm in children, particularly those who receive long-term treatment [4,10].…”