Parents administering highly complex medication regimens require additional supports

Parents of children with chronic conditions make many mistakes when giving lifesaving medicines, according to a study being presented Monday, May 3 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Medication use in children with chronic conditions can be complicated, but little research has been done on mistakes made by parents giving these regimens at home.

Researchers, led by Kathleen E. Walsh, MD, MSc, conducted home visits to determine how often parents make mistakes in administering medications and what types of problems occur.

"Giving these medicines in exactly the right way is vital and sometimes lifesaving for children with chronic conditions," said Dr. Walsh, assistant professor of pediatrics at University of Massachusetts Medical School.

Researchers visited the homes of 83 children ages 6 months to 20 years with cancer, sickle cell disease and epilepsy. They reviewed 544 medications and observed the administration of 166 drugs. Two physicians reviewed potential errors and determined whether a mistake had occurred and its severity.

Medication was administered most often by mothers (79 percent of the time), followed by other guardians (14 percent) and fathers (7 percent).

Although parents and guardians were well-educated (37 percent had a bachelor's degree and 12 percent had advanced degrees), medication errors were common.

"For example, we visited families who did not use the proper syringe to measure liquid medicine or pill cutter to cut tablets, resulting in children getting too little pain medicine or chemotherapy," Dr. Walsh said.

Researchers found 128 medication errors, including 73 with potential to injure the child and 10 errors that actually caused injury. Examples of errors included chemotherapy labels with incorrect dosing instructions (e.g., label said to give six tablets once a day when the child was supposed to take seven tablets once a week) and significant under doses of nonsteroidal anti-inflammatory drugs.

The authors concluded that parents administering highly complex medication regimens require additional supports, even if they are well-educated. "If parents or caregivers are not sure exactly how to give the medicine, they should ask their child's doctor," Dr. Walsh said.