RT Journal Article
SR Electronic
T1 Caregiver Medication Management and Understanding After Pediatric Hospital Discharge
JF Hospital Pediatrics
JO hosppeds
FD American Academy of Pediatrics
SP 844
OP 850
DO 10.1542/hpeds.2019-0036
VO 9
IS 11
A1 Philips, Kaitlyn
A1 Zhou, Roy
A1 Lee, Diana S.
A1 Marrese, Christine
A1 Nazif, Joanne
A1 Browne, Constance
A1 Sinnett, Mark
A1 Tuckman, Steven
A1 Griffith, Kimberly
A1 Kiely, Victoria
A1 Lutz, Marcia
A1 Modi, Anjali
A1 Rinke, Michael L.
YR 2019
UL http://hosppeds.aappublications.org/content/9/11/844.abstract
AB OBJECTIVES: Caregivers frequently make mistakes when following instructions on discharge medications, and these instructions often contain discrepancies. Minimal literature reflects inpatient discharges. Our objective was to describe failures in caregiver management and understanding of inpatient discharge medications and to test the association of documentation discrepancies and sociodemographic factors with medication-related failures after an inpatient hospitalization.METHODS: This study took place in an urban tertiary care children’s hospital that serves a low-income, minority population. English-speaking caregivers of children discharged on an oral prescription medication were surveyed about discharge medication knowledge 48 to 96 hours after discharge. The primary outcome was the proportion of caregivers who failed questions on a 10-item questionnaire (analyzed as individual question responses and as a composite outcome of any discharge medication–related failure). Bivariate tests were used to compare documentation errors, complex dosing, and sociodemographic factors to having any discharge medication-related failure.RESULTS: Of 157 caregivers surveyed, 70% had a discharge medication–related failure, most commonly because of lack of knowledge about side effects (52%), wrong duration (17%), and wrong start time (16%). Additionally, 80% of discharge instructions provided to caregivers lacked integral medication information, such as duration or when the next dose after discharge was due. Twenty five percent of prescriptions contained numerically complex doses. In bivariate testing, only race and/or ethnicity was significantly associated with having any failure (P = .03).CONCLUSIONS: The majority of caregivers had a medication-related failure after discharge, and most discharge instructions lacked key medication information. Future work to optimize the discharge process to support caregiver management and understanding of medications is needed.