Strategies parents use to give children oral medicine: a qualitative study of online discussion forums

Abstract

AimThe aim of this study was to describe strategies parents use to give oral medicine to children.MethodsWe conducted an Internet-based qualitative study of posts from online forums where parents discussed how to give children oral medicine. The posts were analyzed using systematic text condensation. The investigators coded and developed groups iteratively, ending up with a consensus on final themes.ResultsWe included 4581 posts. Parents utilized three main strategies to give oral medicine to children: (1) Open administration give medicine to the child knowingly by changing the palatability, actively involve the child in play or use persuasion; (2) Hidden administration give medicine to the child unknowingly by camouflaging it in food, while sleeping or distracted by another activity; (3) Forced administration force children to take medicine with the use of restraint. Parents expressed three perspectives towards using force: Finding it unproblematic, using force despite not liking it or refusing to use force. No single strategy was described as the obvious first choice, and the strategies were not used in any particular order. Parents who gave up getting their child to ingest the medicine reported to contact the prescriber for a different medication, or stopped the treatment completely.ConclusionsThe three strategies are a robust and precise way to categorize techniques used by parents to give children oral medicine. We suggest that health professionals use the strategies to talk to parents and children about administration of oral medicines.

Requests for new oral antibiotic prescriptions in children within 2 days: a Norwegian population-based study

“…Changed antibiotic prescriptions represent situations of parents in great distress, unable to get their child to take the medicine prescribed to get well (4). In addition, changes from narrow- to broad-spectrum antibiotics may increase children’s short-term risk of side effects (6), and change of intestinal microbiome may result in future sequelae (27), furthering this distress.…”

“…This corresponds with findings that taste is a key characteristic associated with children’s refusal of medicines (31,32) and indicates that prescription changes can be used to identify antibiotics that are challenging for children to use. Changed prescriptions most likely underestimate administration challenges (4) and may contribute to the difference found in chronic children who were 3.8 times more likely to refuse poor-tasting medicines at least once (11). Taste may also explain why poor-tasting liquid penicillin V was most frequently replaced by better-tasting liquid amoxicillin and erythromycin, and even solid penicillin V that is easier to taste mask (33).…”

“…Administering antibiotics to children can be challenging, and French parents reported in a survey that their child spat out at least one dose of antibiotics in 22% of the cases (3). In a recent qualitative study, parents said they battled with unwilling children and used several strategies to administer unpalatable antibiotics (4). If unable to get the child to take the medicine, parents sometimes went to the trouble of requesting a new antibiotic prescription (4,5).…”

“…In a recent qualitative study, parents said they battled with unwilling children and used several strategies to administer unpalatable antibiotics (4). If unable to get the child to take the medicine, parents sometimes went to the trouble of requesting a new antibiotic prescription (4,5). Such requests represent situations of negative interaction between children and parents and may reduce children’s well-being through treatment delay.…”

Register‐based study showed that the age when children were prescribed antibiotic tablets and capsules instead of liquids increased from 2004 to 2016

“…It is easier to mask bad taste in solid than liquid dosage forms (2), both within the intact solid formulations or by using in situ coating (25). Some parents also crush and mix solids with foods, such as chocolate spread or jam, to mask the taste (26). Using solid formulations may therefore improve the acceptability of antibiotics compared to using liquids, and possibly adherence, as shown in previous studies (10).…”