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The World Health Organization Oral Rehydration Solution in US Pediatric Practice
A Randomized Trial to Evaluate Parent Satisfaction
Morissa Ladinsky, MD;
Anne Duggan, ScD;
Mathuram Santosham, MD;
Modena Wilson, MD, MPH
Arch Pediatr Adolesc Med. 2000;154:700-705.
Background The World Health Organization's effective, inexpensive oral rehydration solution (WHO-ORS) is used worldwide, but rarely by US practitioners because, in part, of concerns about parent satisfaction.
Objective To compare caretaker satisfaction with the WHO-ORS, a packet-based solution requiring preparation, with satisfaction with a commercially prepared oral rehydration solution (C-ORS), (Pedialyte; Ross Nutritionals, Columbus, Ohio).
Design and Methods Randomized controlled trial in an urban pediatric clinic and a suburban family medicine clinic. Children aged 3 to 47 months treated as outpatients for diarrhea were randomized to receive either WHO-ORS or C-ORS. After 48 hours of use, caretakers completed a telephone interview measuring satisfaction with aspects of the solution.
Results Of 97 families enrolled, 91 (94%) were available for follow-up interviews. The WHO-ORS and C-ORS groups were comparable at baseline in all respects, except that slightly more caretakers in the latter group had used the C-ORS for the current illness before study enrollment (P=.06). Caretakers in the WHO-ORS group had higher overall satisfaction, satisfaction with cost, willingness to purchase in the future, and to recommend use (P<.001 for all). Differences remained significant after controlling for prior use of the C-ORS. There was no difference in satisfaction with ease of administration (P=.90), appearance (P=.20), and effectiveness (P=.80). No adverse effects attributable to either study solution occurred.
Conclusions Caretakers who prepared and used the WHO-ORS were more satisfied with their solution than a comparable group who administered C-ORS. Fear of parental dissatisfaction need not be a barrier to use of the WHO-ORS in the United States.
From the Divisions of General Pediatrics, Sinai Hospital (Dr Ladinsky) and Johns Hopkins University (Drs Duggan, Santosham, and Wilson), Baltimore, Md. Dr Ladinsky is now with the Division of General Pediatrics, Columbus Children's Hospital, Columbus, Ohio.
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