TY - JOUR
T1 - Parent Dosing Tool Use, Beliefs, and Access
T2 - A Health Literacy Perspective
AU - Williams, Tiffany A.
AU - Wolf, Michael S.
AU - Parker, Ruth M.
AU - Sanders, Lee M.
AU - Bailey, Stacy
AU - Mendelsohn, Alan L.
AU - Dreyer, Benard P.
AU - Velazquez, Jessica J.
AU - Yin, H. Shonna
N1 - Funding Information:
Supported by the National Institutes of Health (NIH)/ National Institute of Child Health and Human Development (NICHD) ( R01HD070864 ). M.W. has served as a consultant to and received grant funding from Merck Sharp and Dohme ; received grant funding via his institution from Eli Lilly ; and has served as a consultant to Luto Ltd and Pfizer Foundation. R.P. has served as a consultant to and received grant funding from Merck Sharp and Dohme, United States . S.B. has served as a consultant to and received grant funding from Merck Sharp and Dohme ; received grant funding via her institution from Eli Lilly ; and has served as a consultant to Luto Ltd and Pfizer Foundation. The other authors declare no conflicts of interest.
Funding Information:
Supported by the National Institutes of Health (NIH)/National Institute of Child Health and Human Development (NICHD) (R01HD070864). M.W. has served as a consultant to and received grant funding from Merck Sharp and Dohme; received grant funding via his institution from Eli Lilly; and has served as a consultant to Luto Ltd and Pfizer Foundation. R.P. has served as a consultant to and received grant funding from Merck Sharp and Dohme, United States. S.B. has served as a consultant to and received grant funding from Merck Sharp and Dohme; received grant funding via her institution from Eli Lilly; and has served as a consultant to Luto Ltd and Pfizer Foundation. The other authors declare no conflicts of interest.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/12
Y1 - 2019/12
N2 - Objectives: To assess parent decision-making regarding dosing tools, a known contributor to medication dosing errors, by evaluating parent dosing tool use, beliefs, and access, and the role of health literacy, with a focus on dosing cups, which are associated with an increased risk of multifold overdose. Study design: Cross-sectional analysis of data collected for randomized controlled study in 3 urban pediatric clinics. English/Spanish-speaking parents (n = 493) of children ≤8 years of age enrolled. Outcomes: reported tool use, beliefs, and access. Predictor variable: health literacy (Newest Vital Sign; limited [0-3], adequate [4-6]). Multiple logistic regression analyses conducted. Results: Over two-thirds of parents had limited health literacy. Oral syringes (62%) and dosing cups (22%) were most commonly used. Overall, 24% believed dosing cups were the best tool type for dosing accuracy; 99% reported having access to ≥1 dosing tools with standard measurement markings. Parents with limited health literacy had greater odds of dosing cup use (limited vs adequate: aOR = 2.4 [1.2-4.6]). Parents who believed that dosing cups are best for accuracy had greater odds of dosing cup use (aOR = 16.3 [9.0-29.3]); this belief mediated health literacy-effects on dosing cup use. Conclusions: Factors associated with dosing tool choice, including parent health literacy and beliefs are important to consider in the design of interventions to reduce dosing errors; future larger-scale studies addressing this issue are needed.
AB - Objectives: To assess parent decision-making regarding dosing tools, a known contributor to medication dosing errors, by evaluating parent dosing tool use, beliefs, and access, and the role of health literacy, with a focus on dosing cups, which are associated with an increased risk of multifold overdose. Study design: Cross-sectional analysis of data collected for randomized controlled study in 3 urban pediatric clinics. English/Spanish-speaking parents (n = 493) of children ≤8 years of age enrolled. Outcomes: reported tool use, beliefs, and access. Predictor variable: health literacy (Newest Vital Sign; limited [0-3], adequate [4-6]). Multiple logistic regression analyses conducted. Results: Over two-thirds of parents had limited health literacy. Oral syringes (62%) and dosing cups (22%) were most commonly used. Overall, 24% believed dosing cups were the best tool type for dosing accuracy; 99% reported having access to ≥1 dosing tools with standard measurement markings. Parents with limited health literacy had greater odds of dosing cup use (limited vs adequate: aOR = 2.4 [1.2-4.6]). Parents who believed that dosing cups are best for accuracy had greater odds of dosing cup use (aOR = 16.3 [9.0-29.3]); this belief mediated health literacy-effects on dosing cup use. Conclusions: Factors associated with dosing tool choice, including parent health literacy and beliefs are important to consider in the design of interventions to reduce dosing errors; future larger-scale studies addressing this issue are needed.
KW - dosing devices
KW - dosing errors
KW - dosing units
KW - medication errors
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U2 - 10.1016/j.jpeds.2019.08.017
DO - 10.1016/j.jpeds.2019.08.017
M3 - Article
C2 - 31604631
AN - SCOPUS:85072999112
SN - 0022-3476
VL - 215
SP - 244-251.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -