BACKGROUND AND OBJECTIVES: Our objective was to determine the level of adult understanding of dosage instructions for a liquid medication commonly prescribed for children. METHODS: Structured interviews were conducted with 373 adults waiting for an appointment at family medicine clinics serving low-income populations in Shreveport, La; Chicago; and Jackson, Mich, from July 2003-August 2004. Subjects were asked to read a prescription label for amoxicillin and explain how they would take the medication. Correct interpretation was determined by a panel of blinded physician reviewers who coded subjects' verbatim responses. Qualitative methods were used to determine the nature of incorrect responses. RESULTS: Twenty-eight percent of subjects misunderstood medication instructions. The prevalence of misinterpreting instructions among subjects with adequate, marginal, and low literacy was 18%, 34%, and 43%, respectively. Common causes for misunderstanding included problems with dosage measurement (28%; ie, tablespoon instead of teaspoon) and frequency of use (33%; ie, every 3 hours instead of every 6-8 hours). In an adjusted analysis that excluded literacy, African Americans were more likely to misunderstand instructions than Caucasians (adjusted odds ratio [AOR] 1.63, 95% confidence interval [CI]=1.02-2.61). When literacy was included in the model, the effect of race on misunderstanding was reduced and nonsignificant. Inadequate and marginal literacy remained independent predictors of misunderstanding (inadequate--AOR 2.90, 95% CI= 1.41-6.00; marginal--AOR 2.20, 95% CI=1.19-3.97). CONCLUSIONS: Misinterpretation of pediatric liquid medication instructions is common. Limited literacy is a significant risk factor for misunderstanding and could contribute to racial disparities. Instructions should be written in a concise manner and standardized to ensure comprehension.
BACKGROUND AND OBJECTIVES: Our objective was to determine the level of adult understanding of dosage instructions for a liquid medication commonly prescribed for children. METHODS: Structured interviews were conducted with 373 adults waiting for an appointment at family medicine clinics serving low-income populations in Shreveport, La; Chicago; and Jackson, Mich, from July 2003-August 2004. Subjects were asked to read a prescription label for amoxicillin and explain how they would take the medication. Correct interpretation was determined by a panel of blinded physician reviewers who coded subjects' verbatim responses. Qualitative methods were used to determine the nature of incorrect responses. RESULTS: Twenty-eight percent of subjects misunderstood medication instructions. The prevalence of misinterpreting instructions among subjects with adequate, marginal, and low literacy was 18%, 34%, and 43%, respectively. Common causes for misunderstanding included problems with dosage measurement (28%; ie, tablespoon instead of teaspoon) and frequency of use (33%; ie, every 3 hours instead of every 6-8 hours). In an adjusted analysis that excluded literacy, African Americans were more likely to misunderstand instructions than Caucasians (adjusted odds ratio [AOR] 1.63, 95% confidence interval [CI]=1.02-2.61). When literacy was included in the model, the effect of race on misunderstanding was reduced and nonsignificant. Inadequate and marginal literacy remained independent predictors of misunderstanding (inadequate--AOR 2.90, 95% CI= 1.41-6.00; marginal--AOR 2.20, 95% CI=1.19-3.97). CONCLUSIONS: Misinterpretation of pediatric liquid medication instructions is common. Limited literacy is a significant risk factor for misunderstanding and could contribute to racial disparities. Instructions should be written in a concise manner and standardized to ensure comprehension.
Authors: Alejandro Torres; Ruth M Parker; Lee M Sanders; Michael S Wolf; Stacy Cooper Bailey; Deesha A Patel; Jessica J Jimenez; Kwang-Youn A Kim; Benard P Dreyer; Alan L Mendelsohn; H Shonna Yin Journal: Acad Pediatr Date: 2017-04-08 Impact factor: 3.107
Authors: H Shonna Yin; Benard P Dreyer; Hannah A Moreira; Linda van Schaick; Luis Rodriguez; Susanne Boettger; Alan L Mendelsohn Journal: Acad Pediatr Date: 2014 May-Jun Impact factor: 3.107
Authors: H Shonna Yin; Benard P Dreyer; Donna C Ugboaja; Dayana C Sanchez; Ian M Paul; Hannah A Moreira; Luis Rodriguez; Alan L Mendelsohn Journal: Pediatrics Date: 2014-07-14 Impact factor: 7.124
Authors: H Shonna Yin; Ruth M Parker; Lee M Sanders; Alan Mendelsohn; Benard P Dreyer; Stacy Cooper Bailey; Deesha A Patel; Jessica J Jimenez; Kwang-Youn A Kim; Kara Jacobson; Michelle C J Smith; Laurie Hedlund; Nicole Meyers; Terri McFadden; Michael S Wolf Journal: Pediatrics Date: 2017-07 Impact factor: 7.124