Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago 60611-2605, USA.
Patient Educ Couns. 2013 May;91(2):255-60. doi: 10.1016/j.pec.2012.12.017. Epub 2013 Feb 18.
Assess accuracy of caregiver understanding of children's prescribed medications and examine factors associated with accurate recall.
Cross-sectional, observational study of English- or Spanish-speaking caregivers of primary care patients aged 0-7 years. Child and visit characteristics and caregiver health literacy (short test of health literacy in adults) were assessed. Post-visit, caregivers completed questionnaires on medications prescribed. Caregiver and medical record agreement on medication name and administration (dose and frequency) were examined using chi square and logistic regression.
Analyses included 68 caregivers (28% low health literacy); 96% of children had public insurance. Caregivers indicated that the doctor provided clear medication information (100%) and they could follow instructions (98%). 101 medicines were prescribed; 6 were recalled by caregiver only. 71% of medications were accurately named; 37% of administration instructions were accurately recalled. Accurate naming was more often found for patients 3-7 years, without conditions requiring repeat visits, and new medications. Accurate administration responses were associated with having only 1 child at the visit.
Unperceived medication instruction understanding gaps exist at physician visits for caregivers of all literacy levels. Communication and care delivery practices need further evaluation.
Clinicians should be aware of the frequency of caregiver medication misunderstanding.
评估照料者对儿童规定药物的理解准确性，并研究与准确回忆相关的因素。
对接受初级保健患者（0-7 岁）的英语或西班牙语照料者进行横断面、观察性研究。评估儿童和就诊特征以及照料者健康素养（成人健康素养简短测试）。就诊后，照料者完成有关规定药物的问卷。使用卡方检验和逻辑回归分析评估照料者和医疗记录在药物名称和给药（剂量和频率）方面的一致性。
分析纳入 68 名照料者（28%健康素养较低）；96%的儿童拥有公共保险。照料者表示医生提供了明确的药物信息（100%），他们可以遵循医嘱（98%）。开了 101 种药物；只有 6 种药物仅由照料者回忆。71%的药物名称准确；37%的给药说明准确回忆。对于 3-7 岁、无需多次就诊和新药物的患者，准确命名的情况更为常见。准确的给药反应与就诊时只有 1 个孩子有关。
在所有健康素养水平的照料者就诊时，医生的药物指导理解存在未被察觉的差距。需要进一步评估沟通和护理实施实践。
临床医生应意识到照料者药物误解的频率。
