Rungvivatjarus Tiranun, Huang Maria Z, Winckler Britanny, Fisher Erin S, Rhee Kyung E
Department of Pediatrics, University of California San Diego, San Diego, CA, United States.
Division of Pediatric Hospital Medicine, Rady Children's Hospital, San Diego, CA, United States.
Front Health Serv. 2025 Jun 12;5:1569531. doi: 10.3389/frhs.2025.1569531. eCollection 2025.
While families with limited English proficiency and/or low health literacy face increased risks of medication errors, poor medication management, and non-adherence, little is known about the barriers pediatric medical providers experience when educating families on medication use and compliance. This study explores provider-reported barriers and proposed solutions to improving medication management.
Focus group discussions were selected to obtain data as they can provide rich insight into participants' perspectives. From December 2019 to September 2020, focus group discussions were conducted with pediatric providers from four clinics located in Medically Underserved Areas/Medically Underserved Populations/or Health Professional Shortage Areas, which are geographic areas/populations with limited primary care access. Initially held in person, focus groups shifted to virtual formats during the COVID-19 pandemic. Two investigators independently coded each focus group in an iterative process and worked with a third investigator to discuss and refine emergent themes via inductive thematic analysis.
Sixteen providers participated across four focus groups. Four major themes were reported as barriers: (1) time constraints, (2) provider's lack of medication and logistical knowledge, (3) incomplete or absent patient medication information, and (4) complexity/inefficiency of the electronic health records system (EHR). Providers identified three possible solutions to such barriers: (1) EHR optimization or technology tools, (2) dedicated medication educators, and (3) video/graphic tools.
Pediatric providers face barriers in supporting families with medication management including lack of time, knowledge, information, effective EHR. Proposed solutions such as improved technology, dedicated educators, and visual aids may help address these issues while potentially decreasing medication errors.
英语水平有限和/或健康素养较低的家庭面临用药错误、用药管理不善和不依从性增加的风险，但对于儿科医疗服务提供者在对家庭进行用药使用和依从性教育时所面临的障碍知之甚少。本研究探讨了医疗服务提供者报告的障碍以及改善用药管理的建议解决方案。
选择焦点小组讨论来获取数据，因为它们可以深入了解参与者的观点。2019年12月至2020年9月，对位于医疗服务不足地区/医疗服务不足人群/或卫生专业人员短缺地区（即初级保健可及性有限的地理区域/人群）的四家诊所的儿科医疗服务提供者进行了焦点小组讨论。焦点小组最初以面对面的形式进行，在新冠疫情期间改为虚拟形式。两名研究人员在一个迭代过程中对每个焦点小组进行独立编码，并与第三名研究人员合作，通过归纳主题分析来讨论和完善新出现的主题。
四个焦点小组共有16名医疗服务提供者参与。报告了四个主要障碍主题：（1）时间限制，（2）医疗服务提供者缺乏用药和后勤知识，（3）患者用药信息不完整或缺失，（4）电子健康记录系统（EHR）的复杂性/低效性。医疗服务提供者确定了应对这些障碍的三种可能解决方案：（1）优化EHR或技术工具，（2）专门的用药教育人员，（3）视频/图形工具。
儿科医疗服务提供者在支持家庭进行用药管理方面面临障碍，包括时间、知识、信息和有效的EHR方面的不足。诸如改进技术、专门的教育人员和视觉辅助工具等建议解决方案可能有助于解决这些问题，并有可能减少用药错误。
