Development and evaluation of tools to improve pediatric medication administration by parents

• Applicant: Dr. Alexander Send
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: from 2015 to 2017
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 310436544

In pediatric outpatient care, most medication errors are caused by improper medication administration by parents. This can potentially result in adverse drug events. The risk of medication errors is especially high with oral liquid pediatric medications because of dosing errors or inaccurate dose measurements. Although parents need adequate and comprehensible instructions, over 50% of parents do not receive any instructions. Furthermore, even upon receiving information, up to 60% struggle to put instructions into practice. Besides the package leaflet, there are currently no easily accessible and standardized tools for parents to calculate and administer the right dose of oral liquid pediatric medication in the outpatient setting. Thus, it is not known if and how such tools would impact parents' knowledge and medication administration competencies. This project therefore aims to improve pediatric outpatient care by providing parents administering oral liquid medication with newly developed tools. Instruction leaflets and a dose calculator to calculate correct doses will be developed, and their benefit and impact on knowledge and medication administration competencies evaluated. First, information on correct dosing, calculating, and administering of error-prone oral liquid pediatric medications will be collected and used to create paper-based information leaflets and an electronic calculation aid. Parents will evaluate the instruction leaflets by responding to structured questions pertaining to layout, comprehensibility, and content. The leaflet will subsequently be optimized. This standardized approach facilitates a generic assessment and transferability to other languages. Parents will measure a predefined dose to assess the leaflet's impact on their drug administration competency. Understanding of the leaflet and actual dosing competency will be correlated to evaluate to what extent knowledge and comprehension assessment can serve as surrogate parameters for actual competency. Additional characteristics influencing comprehension (e.g. education level) will also be assessed. The dose calculator will be evaluated in a randomized controlled pilot study with parents. Dose calculation of an intervention group (with dose calculator) will be compared to a control group (common dosage recommendation). In addition, characteristics that could influence the dose calculation process (e.g. former experiences) will be documented. Based on the results, an electronic platform for parents will subsequently be created to support the pediatric medication administration process in Germany. This platform will be equally useful to caregivers administering medication and to health care providers prescribing or dispensing oral liquid pediatric medication. This will thereby improve pediatric medication administration.

• DFG Programme: Research Fellowships
• International Connection: USA
• Host: Professorin Dr. Rainu Kaushal