Realising the issues of medicine administration to the young (REMEDY)
Research type
Research Study
Full title
The nature of medication administration and dosing issues in children and young people: parental, informal caregiver and young people’s experiences - a two-phase study
IRAS ID
258491
Contact name
Chi Huynh
Contact email
Sponsor organisation
Aston University
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
Medication use is an essential component of the patient healthcare cycle; however, medication errors occur frequently particularly among children and young people, commonly at the medication administration stage.
Medication errors have been defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer”.
Evidence suggests that parents and informal caregivers make frequent errors when administrating medications to their children, with 50% of them having measured or administered an incorrect dose. Prior studies in paediatric health settings found that parents with limited health literacy are associated with knowledge gaps, dosing errors and poor understanding of medication labels, which can lead to errors in medication administration.
To our knowledge, little is known about the nature of medication administration issues among children and young people aged 0 to 18 years old in the UK. This project aims to identify the specific problems of medication administration to children and young people at home, from both a parent / informal caregiver perspective, as well as the experiences of young people taking medicines themselves.
Parents or informal caregivers of children aged up to 18 years, and young people aged between 16 to 18 years, who are currently in receipt of prescribed oral medication at home and are attending the hospital or are part of Aston University staff and students, will be recruited to take part in a two-phase study. During phase-one, parents or informal caregivers will be interviewed to discuss their issues regarding their children`s medication, whilst young people will be interviewed to talk about their own challenges when taking medicines. In phase two of the study, participants will be invited to prepare two sets of placebo oral liquids to assess for dose accuracy.
The information obtained from the study will further enable us to ascertain types of medication administration errors occurring in the UK among children aged 0 to 18 years old and their families in a home setting, and ultimately design a model to minimise medication administration-related errors.
Summary of Results
Medication errors frequently occur with paediatric patients who take long term medication at home, where parents/caregivers are responsible for administering the medication.
The issues and the extent to which they can affect medication safety and accuracy in the UK have not been formally established.
Therefore, this thesis aimed to investigate medication administration problems, issues and challenges occurring at home among children and young people aged 0 to 18 years old, where parents and patients were responsible for administering their medication. The REMEDY was done as part 3 of the thesis.
Part 1 of the thesis
A systematic review of medication administration problems for paediatrics caused by parents/caregivers, including the role of health literacy, found that there is little literature other than that published in the USA that has examined medication administration problems using a validated health literacy tool.Part 2 of the thesis
From the survey conducted among paediatric pharmacists regarding this issue (preliminary study), the respondents indicated that the consultation time between the patient and the pharmacist is critical to reducing medication administration problems. Furthermore, a few suggested there is a need for further training and educational material for parents and young people to improve understanding in regards to medication use at home.Part 3 of the thesis (REMEDY study)
Forty-nine parents and young people were interviewed from five sites in England regarding issues and problems related to administering medicines to children and young persons aged 0-18 years (Phase 1). The participants suggested a few recommendations that could help them administer or take medication safely at home; this includes a visual demonstration of the dose to be administered. Finally, 40 participants were recruited in the observational session (Phase 2), where they were asked to draw up various volumes of cherry syrup and normal saline using oral syringes and administering instruments used for paediatric medicines administration in practice. It was found that dose accuracy for both liquids varied across each dose volumes. And there was a significant association of dose accuracy with measurement tool size, type and dose volume.This work provides evidence that the parents/carer of children and young people require assistance to ensure safe medication administration at home. Future work is needed to develop a complex intervention to address the issues.
REC name
West Midlands - Black Country Research Ethics Committee
REC reference
19/WM/0142
Date of REC Opinion
18 Jun 2019
REC opinion
Further Information Favourable Opinion