Drug information leaflets improve parental knowledge of their child's treatment at paediatric emergency department discharge

Abstract

BackgroundHospital discharge is a complex multidisciplinary process that can lead to non-compliance and drugs-related problems. Crucial issue for children is parental knowledge of discharge treatments, especially in the time-limited and stressful environment of an emergency department (ED).ObjectiveTo compare parental correct knowledge of treatment with and without supply of customised drug information leaflets for the 10 most commonly prescribed drugs.MethodInclusion criteria: paediatric patients (0–16 years) with French-speaking parents discharged from ED of the paediatric department of Geneva University Hospitals before (phase A) and after (phase B) intervention.InterventionSupply and brief comment of drug information leaflets focusing on specific information not available in official drugs information documents. Follow-up Semi-structured phone interview within 72 h after discharge to evaluate the percentage of parents with correct knowledge of dose, frequency, duration and indication of drugs. Multivariate analysis to identify factors associated with correct knowledge (phases A/B, drugs collection at usual pharmacy, drugs categories).Results125 patients were included (phase A: 56; phase B: 69). Drug information leaflets were given to 63/69 ED patients (91%), covering 96/138 prescribed drugs (70%). Parental knowledge was significantly improved in phase B (dose: 62.3% to 89.1%; frequency: 57.9% to 85.5%; duration: 34.2% to 66.7%; indication: 70.2% to 94.9%; p<0.0001). Phase B and collection of drugs at usual pharmacy were significant factors associated with correct knowledge.ConclusionsDrug information leaflets significantly improved treatment knowledge of French-speaking parents after paediatric ED discharge. Leaflets are now available online for general population.

Parental Management of Discharge Instructions: A Systematic Review

“…Other studies were performed in Canada, 33,36,38,52,57,69,86 Israel, 82,83 Australia, 59 Rwanda, 39 Taiwan, 89 India, 79 Uganda, 87 Saudi Arabia, 53 and Switzerland. 65 In the following sections, studies will be summarized by domain of care. Table 1 summarizes pertinent information about these studies, while Supplementation Table 3 provides more detailed information.…”

“…¶ Researchers for many studies assessed knowledge of multiple subdomains of medication instructions (eg, dose, frequency, duration) as a conglomerate outcome, 49,54,61,82,83 whereas researchers for 1 study assessed whether parents were aware if a change was made to the medication regimen. 56 The percent of parents with accurate subdomain-specific knowledge varied on the basis of the study and specific subdomain: 62% to 94% knew the correct medication dose, 50 94% frequency, 50,53,65,81 24% to 87% name, 50,53,61 34% to 65% duration, 53,65 70% to 91% indication, 50,65 and 47% side effects. 53 Studies in which execution of medication instructions was assessed fell into 2 categories: medication dosing or adherence.…”

Caregiver Medication Management and Understanding After Pediatric Hospital Discharge

“…To develop the questionnaire, the research team integrated questions related to medication name, dose, frequency, duration, adherence, desired effects, and expected side effects from previous studies [8][9][10][11][12][13][14] with questions related to knowledge of new prescriptions and timing of the next dose due after discharge. Lastly, a question for assessing caregiver difficulty in obtaining medications from the pharmacy was asked to analyze adherence behaviors and in preparation for work to improve our institution' s process.…”

“…Studies from emergency departments (EDs) reveal that caregivers have difficulty managing all discharge instructions, especially those related to medications. 5 Caregivers of children discharged from the ED frequently cannot recall medication name, [8][9][10][11] frequency, 8,9,11,12 duration, 9,11,12 indications, 8,12 and side effects. 9 Additionally, up to 38% report medication nonadherence.…”

“…15,16 Because the majority of this work is focused on ED rather than inpatient discharge, the unique challenges related to caregiver medication management and understanding after pediatric hospital discharge remain understudied. 5,[8][9][10][11][12][13] In addition, medication documentation discrepancies at care transitions are common, disadvantaging caregivers in correctly conducting discharge tasks.…”