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Do Parents Give What They Intend to Give?

Harold K. Simon, MD; David A. Weinkle, MD

Arch Pediatr Adolesc Med. 1997;151(7):654-656.

Abstract
Objective
To evaluate caregiver (parent or guardian) use of over-the-counter medications (OTCs) as related to the accuracy and correctness of dosing for children seen at a pediatric emergency department with nonemergent concerns.

Design
Prospective patient series.

Setting
A tertiary care pediatric emergency center.

Participants
A representative sample of children with nonemergent chief complaints.

Interventions
A questionnaire about general demographic characteristics, recent OTC use, and medical history of the patients was given to each caregiver. A mock scenario was then presented that required the caregivers to determine and measure a correct dose of acetaminophen for their child. A dose of 9 to 16.5 mg/kg was considered correct. Accuracy of measuring was considered within ±20% of the caregivers' stated intended dose for their child.

Results
One hundred caregivers were enrolled in the study. Mean caregivers' age was 29 years, with 82% having at least a high school education. Seventy-seven percent of their children used OTCs within the previous 2 months, and Tylenol (acetaminophen) was the most commonly used. While 66% of the caregivers reported Tylenol use, only 8% reported the use of acetaminophen. During the dosing scenario, only 40 % of the caregivers stated an appropriate dose for their child and only 67% accurately measured the amount of acetaminophen they intended. Forty-three percent measured out a correct amount of acetaminophen for their child. However, almost one third of these occurred strictly by accident because they inaccurately measured an improper intended dose. Combining these results, only 30% of the caregivers were able to demonstrate both an accurately measured and correct dose for their child.

Conclusions
Although a large number of caregivers administer OTCs, knowledge of these medications, and accuracy and correctness of dosing remain a marked concern. Improved caregiver education on the accuracy and correctness of dosing OTCs is necessary.

Arch Pediatr Adolesc Med. 1997;151:654-656

Author Affiliations
From the Department of Pediatrics, Division of Emergency Medicine, Egleston Children's Hospital, Emory University School of Medicine (Drs Simon and Weinkle), and Scottish Rite Children's Medical Center (Dr Weinkle), Atlanta, Ga.

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