Understanding of Information about Medicines Use among Parents of Pre-School Children in Serbia: Parental Pharmacotherapy Literacy Questionnaire (PTHL-SR)

Abstract

Parental health literacy plays an important role in children’s health. Experiences from pharmacy practice show that is necessary to check if parents understand instructions about use of medicines for children. This study aimed to assess pharmacotherapy literacy of parents of pre-school children and to examine association of parental pharmacotherapy literacy level with parent’s socio-demographic characteristics. The study was cross-sectional, conducted among parents of pre-school children (1–7 years of age), in kindergartens in several municipalities of Belgrade, Serbia, during regular parents meetings, from May to October 2016. Functional health literacy was measured by the Serbian version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Parental pharmacotherapy literacy was assessed with newly constructed PTHL-SR questionnaire with good psychometric characteristics (Parental pharmacotherapy literacy questionnaire—Serbian). Overall, 813 parents participated in the study, mostly females (81.30%), between 30 to 40 years of age (70.85%) with two children (56.70%). Almost all of our study participants (99%) had adequate health literacy as assessed by S-TOFHLA. Mean score on PTHL-SR was 72.83% (standard deviation was 13.37), with better results among females than males (72% of women were in the group of highest PTHL-SR results). Our study showed that many parents (76.5%) knew the appropriate usage of non-prescription medicine for children, 57.2% parents were able to correctly calculate the dose of oral syrup for a child, and only 43.3% were able to interpret non-prescription dosage information written on the package. The majority of parents (61.3%) would make a dosage to child based on age and not on their weight. Every fifth parent with adequate functional health literacy measured by S-TOFHLA test, achieved the lowest results measured by PTHL-SR. Higher performance of the PTHL-SR was significantly correlated with education (p < 0.001), female sex (p < 0.001), married parents and those living in common-law (p < 0.001), older parents (p < 0.05) and parents who have more children (p < 0.05), and are non-smokers (p < 0.05). These results provide evidence that limitations in understanding common information about use of medicines are widespread among parents of pre-school children and encourage efforts for further investigation. PTHL-SR questionnaire may be a useful tool for identification of parents who need more instructions and assistance from healthcare providers, above all in providing better communication, written or spoken at community pharmacy settings.

The Development and Psychometric Assessment of Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP)

“…Furthermore, patients' skills, e.g., how to interpret medication labels such as dosing and measurements was also emphasized in the development of medication literacy measure (Sauceda et al, 2012). In addition, King, Ubavić et al and Krajnović et al referred to four domains of pharmacotherapy literacy: knowledge, understanding for health information (written and spoken), numeracy, and access to medicinerelated information (King et al 2011;Ubavićet al, 2018a;Ubavićet al, 2018b;Krajnovic, 2019). The understanding for written or spoken information and numeracy were also emphasized in the concept of pharmacotherapy literacy.…”

“…Knowledge for medication specific for patients with certain kinds of disease was also incorporated in the concept of pharmacotherapy literacy and medication literacy (King et al, 2011;Sauceda et al, 2012;Ubavićet al, 2018a;Ubavićet al, 2018b;Krajnović et al, 2019). Therefore, knowledge for hypertension disease, treatment principal, and antihypertensives taking has been applied into operationalizing medication literacy for hypertensive patients in this present study.…”

Pharmacotherapy Literacy and Parental Practice in Use of Over-the-Counter Pediatric Medicines

“…For instance, every third parent thinks that antipyretic should be given for every fever case [9]. Our study on pharmacotherapy literacy among parents of pre-school children in Serbia has shown that every fifth parent has difficulty understanding information that is given either in written or spoken form about the use of medicines [10]. Unintentional errors in the use of pediatric medicines made by parents can be very frequent and could be due to lack of knowledge and low levels of pharmacotherapy literacy [6,7].…”

“…These errors are often related to liquid pediatric medicines, mainly antipyretics [14,15]. Socio-demographic characteristics, such as number of children, parental age, and level of education were reported to be factors that influenced the usage of antipyretic medicines [10].…”

Maternal education, health profession and cigarette smoking are decisive factors for self-medication in children by parents

“…Insufficient parental pharmacotherapy literacy was found to be an additional problem. Ubavic et al (5) found that more than half of parents (56.7 %) of pre-school children in Serbia were not able to properly understand the dosage regimen of over-the-counter (OTC) medicines on the package label and in patient information leaflets. Around the same percentage of parents in France do not properly prepare and reconstitute oral antibiotics, resulting in a risk of underdose or overdose (6).…”