Outpatient advice on pediatric medication safety is inadequate

Child/Adolescent Health
Outpatient advice on pediatric medication safety is inadequate

Children are particularly vulnerable to medication safety errors. When they occur, such errors usually happen during the administration stage when several individuals might be responsible for getting the medication to the child. Yet a new study reveals that little advice is being given to parents on medication safety in the ambulatory setting. If it is given by office and pharmacy personnel, the advice is often incomplete.

Researchers collected data on 1,685 children who received care from 6 office practices in Boston. Information was gathered from chart and prescription reviews. Parents were also interviewed at 10 days after the child's first visit and then again 2 months later. Parents were asked when information on medication safety was provided, by whom, and the content of such advice. The researchers also identified medication errors that occurred, any near misses, as well as any adverse drug events.

Providers did give information on why the medication was being given (indication) most of the time (91 percent). However, they only mentioned side effects 28 percent of the time. Only 14 percent of the time was written information given to parents on medication safety issues. While pharmacies were good at giving written information (82 percent), only 19 percent of prescriptions came with advice on the drug's indication. Even fewer prescriptions (9 percent) were accompanied by advice on medication side effects. Overall, 57 percent of families did not receive information because it was not presented to them, rather than that they refused it. The researchers propose that novel strategies are needed to deliver advice using Web-based technologies and motivational interviewing techniques. The study was supported in part by the Agency for Healthcare Research and Quality (HS11534).

See "The role of advice in medication administration errors in the pediatric ambulatory setting," by Claire Lemer, M.B.B.S., M.R.C.P.C.H., David W. Bates, M.D., M.Sc., and others in the Journal of Pediatric Safety 5(3), pp. 168-175, 2009.