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Acad Pediatr. 2014 May-Jun;14(3):262-70. doi: 10.1016/j.acap.2014.01.003.

Liquid medication dosing errors in children: role of provider counseling strategies.

Author information

1
Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY. Electronic address: yinh02@med.nyu.edu.
2
Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY.
3
Department of Pediatrics, New York University School of Medicine and Woodhull Medical Center, New York, NY.

Abstract

OBJECTIVE:

To examine the degree to which recommended provider counseling strategies, including advanced communication techniques and dosing instrument provision, are associated with reductions in parent liquid medication dosing errors.

METHODS:

Cross-sectional analysis of baseline data on provider communication and dosing instrument provision from a study of a health literacy intervention to reduce medication errors. Parents whose children (<9 years) were seen in 2 urban public hospital pediatric emergency departments (EDs) and were prescribed daily dose liquid medications self-reported whether they received counseling about their child's medication, including advanced strategies (teachback, drawings/pictures, demonstration, showback) and receipt of a dosing instrument. The primary dependent variable was observed dosing error (>20% deviation from prescribed). Multivariate logistic regression analyses were performed, controlling for parent age, language, country, ethnicity, socioeconomic status, education, health literacy (Short Test of Functional Health Literacy in Adults); child age, chronic disease status; and site.

RESULTS:

Of 287 parents, 41.1% made dosing errors. Advanced counseling and instrument provision in the ED were reported by 33.1% and 19.2%, respectively; 15.0% reported both. Advanced counseling and instrument provision in the ED were associated with decreased errors (30.5 vs. 46.4%, P = .01; 21.8 vs. 45.7%, P = .001). In adjusted analyses, ED advanced counseling in combination with instrument provision was associated with a decreased odds of error compared to receiving neither (adjusted odds ratio 0.3; 95% confidence interval 0.1-0.7); advanced counseling alone and instrument alone were not significantly associated with odds of error.

CONCLUSIONS:

Provider use of advanced counseling strategies and dosing instrument provision may be especially effective in reducing errors when used together.

KEYWORDS:

adherence; ambulatory care; health literacy; medication error; parents; patient communication; patient education

PMID:
24767779
PMCID:
PMC4034520
DOI:
10.1016/j.acap.2014.01.003
[Indexed for MEDLINE]
Free PMC Article
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