Caitlin Naureckas Li1, Carlos A Camargo2, Mohammad Faridi2, Janice A Espinola2, Bryan D Hayes3, Stephen Porter4, Ari Cohen2, Margaret Samuels-Kalow2. 1. Division of Pediatric Infectious Diseases, Boston Children's Hospital, Boston, MA. Electronic address: caitlin.li@childrens.harvard.edu. 2. Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA. 3. Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; Department of Pharmacy, Massachusetts General Hospital, Boston, MA. 4. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Emergency Medicine, Cincinnati Children's Hospital, Cincinnati, OH.
Abstract
STUDY OBJECTIVE: This study sought to determine whether a brief intervention at the time of emergency department (ED) discharge can improve safe dosing of liquid acetaminophen and ibuprofenby parents or guardians. METHODS: We performed a randomized controlled trial in the ED of parents and guardians of children 90 days to 11.9 years of age who were discharged withacetaminophen or ibuprofen, or both. Families were randomized to standard care or a teaching intervention combining lay language, simplified handouts, provision of an unmarked dosing syringe, and teach-back to confirm correct dosing. Participants were called 48 to 72 hours and 5 to 7 days after ED discharge to assess understanding of correct dosing. The primary outcome was defined as parent or guardian report of safe dosing at the time of first follow-up call. Our primary hypothesis was that the intervention would decrease the rate of error from 30% to 10% at 48- to 72-hour follow-up. RESULTS:We enrolled 149 of 259 (58%) eligible subjects; 97 of 149 (65%) were reached at first follow-up call, of whom 35 of 97 (36%) received the intervention. Among those participants receiving the intervention, 25 of 35 (71%) were able to identify a safe dose for their child at the time of the first call compared with 28 of 62 (45%) of those in the control arm. The difference in proportions was 26% (95% confidence interval [CI] 7% to 46%). There was a 58% increase in reporting safe dosing in the intervention group compared with the control roup (relative risk 1.58; 95% CI 1.12 to 2.24), and it remained significant after adjustment for health literacy and language (adjusted relative risk 1.50; 95% CI 1.06 to 2.13). CONCLUSIONS: A multifaceted intervention at the time of ED discharge-consisting of a simplified dosing handout, a teaching session, teach-back, and provision of a standardized dosing device-can improve parents' knowledge of safe dosing of liquid medications at 48 to 72 hours.
RCT Entities:
STUDY OBJECTIVE: This study sought to determine whether a brief intervention at the time of emergency department (ED) discharge can improve safe dosing of liquid acetaminophen and ibuprofen by parents or guardians. METHODS: We performed a randomized controlled trial in the ED of parents and guardians of children 90 days to 11.9 years of age who were discharged with acetaminophen or ibuprofen, or both. Families were randomized to standard care or a teaching intervention combining lay language, simplified handouts, provision of an unmarked dosing syringe, and teach-back to confirm correct dosing. Participants were called 48 to 72 hours and 5 to 7 days after ED discharge to assess understanding of correct dosing. The primary outcome was defined as parent or guardian report of safe dosing at the time of first follow-up call. Our primary hypothesis was that the intervention would decrease the rate of error from 30% to 10% at 48- to 72-hour follow-up. RESULTS: We enrolled 149 of 259 (58%) eligible subjects; 97 of 149 (65%) were reached at first follow-up call, of whom 35 of 97 (36%) received the intervention. Among those participants receiving the intervention, 25 of 35 (71%) were able to identify a safe dose for their child at the time of the first call compared with 28 of 62 (45%) of those in the control arm. The difference in proportions was 26% (95% confidence interval [CI] 7% to 46%). There was a 58% increase in reporting safe dosing in the intervention group compared with the control roup (relative risk 1.58; 95% CI 1.12 to 2.24), and it remained significant after adjustment for health literacy and language (adjusted relative risk 1.50; 95% CI 1.06 to 2.13). CONCLUSIONS: A multifaceted intervention at the time of ED discharge-consisting of a simplified dosing handout, a teaching session, teach-back, and provision of a standardized dosing device-can improve parents' knowledge of safe dosing of liquid medications at 48 to 72 hours.
Authors: Francisco Miguel Escandell-Rico; Juana Perpiñá-Galvañ; Lucía Pérez-Fernández; Ángela Sanjuán-Quiles; Piedras Albas Gómez-Beltrán; Juan Diego Ramos-Pichardo Journal: Int J Environ Res Public Health Date: 2021-04-02 Impact factor: 3.390
Authors: Martina P Neininger; Sarah Jeschke; Lisa M Kiesel; Thilo Bertsche; Astrid Bertsche Journal: World J Pediatr Date: 2021-11-13 Impact factor: 2.764