Yin H Shonna, Dreyer Benard P, van Schaick Linda, Foltin George L, Dinglas Cheryl, Mendelsohn Alan L
Department of Pediatrics, New York University School of Medicine, 550 First Ave, NBV 8S4-11, New York, NY 10016, USA.
Arch Pediatr Adolesc Med. 2008 Sep;162(9):814-22. doi: 10.1001/archpedi.162.9.814.
To evaluate the efficacy of a pictogram-based health literacy intervention to decrease liquid medication administration errors by caregivers of young children.
Randomized controlled trial.
Urban public hospital pediatric emergency department.
Parents and caregivers (N = 245) of children aged 30 days to 8 years who were prescribed liquid medications (daily dose or "as needed").
Medication counseling using plain language, pictogram-based medication instruction sheets. Control subjects received standard medication counseling.
Medication knowledge and practice, dosing accuracy, and adherence.
Of 245 randomized caregivers, 227 underwent follow-up assessments (intervention group, 113; control group, 114). Of these, 99 were prescribed a daily dose medication, and 158 were prescribed medication taken as needed. Intervention caregivers had fewer errors in observed dosing accuracy (>20% deviation from prescribed dose) compared with caregivers who received routine counseling (daily dose: 5.4% vs 47.8%; absolute risk reduction [ARR], 42.4% [95% confidence interval, 24.0%-57.0%]; number needed to treat [NNT], 2 [2-4]; as needed: 15.6% vs 40.0%; ARR, 24.4% (8.7%-38.8%); NNT, 4 [3-12]). Of intervention caregivers, 9.3% were nonadherent (ie, did not give within 20% of the total prescribed doses) compared with 38.0% of controls (ARR, 28.7% [11.4%-43.7%]; NNT, 3 [2-9]). Improvements were also seen for knowledge of appropriate preparation for both medication types, as well as knowledge of frequency for those prescribed daily dose medications.
A plain language, pictogram-based intervention used as part of medication counseling resulted in decreased medication dosing errors and improved adherence among multiethnic, low socioeconomic status caregivers whose children were treated at an urban pediatric emergency department.
clinicaltrials.gov Identifier: NCT00537433.
评估基于象形图的健康素养干预措施对减少幼儿看护者液体药物给药错误的效果。
随机对照试验。
城市公立医院儿科急诊科。
30天至8岁儿童的家长及看护者（N = 245），这些儿童需服用液体药物（每日剂量或“按需服用”）。
使用通俗易懂的语言、基于象形图的用药指导单进行用药咨询。对照组接受标准用药咨询。
用药知识与实践、剂量准确性及依从性。
245名随机分组的看护者中，227名接受了随访评估（干预组113名；对照组114名）。其中，99名被开具每日剂量药物，158名被开具按需服用药物。与接受常规咨询的看护者相比，干预组看护者在观察到的剂量准确性方面错误更少（每日剂量：5.4% 对47.8%；绝对风险降低率[ARR]，42.4% [95%置信区间，24.0% - 57.0%]；需治疗人数[NNT]，2 [2 - 4]；按需服用：15.6% 对40.0%；ARR，24.4% [8.7% - 38.8%]；NNT，4 [3 - 12]）。干预组看护者中，9.3%不依从（即给药量未在规定总剂量的20%范围内），而对照组为38.0%（ARR，28.7% [11.4% - 43.7%]；NNT，3 [2 - 9]）。对于两种药物类型的正确调配知识以及每日剂量药物的服药频率知识也有改善。
作为用药咨询一部分的通俗易懂的、基于象形图的干预措施，可减少多民族、社会经济地位较低的看护者在城市儿科急诊科为其子女用药时的给药错误，并提高依从性。
clinicaltrials.gov标识符：NCT00537433。
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