Parents' pain medication underdosing is associated with more emergency department visits in sickle cell disease. Pediatr Blood Cancer 2018 Apr;65(4)
Date
12/13/2017Pubmed ID
29230919Pubmed Central ID
PMC5821544DOI
10.1002/pbc.26906Scopus ID
2-s2.0-85042281352 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
OBJECTIVE: To determine the association between health literacy, medication knowledge, and pain treatment skills with emergency department (ED) use of parents of children with sickle cell disease (SCD).
METHODS: Parents of children 1- to 12-years-old with SCD were enrolled. Health literacy was assessed using the Newest Vital Sign. Parents completed a structured interview assessing knowledge of the dosage and frequency of home pain medications and an applied skills task requiring them to dose a prescribed pain medication. Underdosage was defined by too small a dose (dosage error) or too infrequent a dose (frequency error). The association between medication knowledge and applied skills with ED visits for pain over the past year was evaluated using Poisson regression adjusting for genotype.
RESULTS: One hundred parent/child pairs were included; 50% of parents had low health literacy. Low health literacy was associated with more underdose frequency errors (38% vs. 19%, P = 0.02) on the skills task. On medication knowledge, underdose dosage errors (adjusted incidence rate ratio [aIRR] 2.0, 95% confidence interval [CI] 1.3-3.0) and underdose frequency errors (aIRR, 1.7, 95% CI 1.2-2.6) were associated with a higher rate of ED visits for pain. On the skills task, underdose dosage errors (aIRR 1.6, 95% CI 1.1-2-.4) and underdose frequency errors were associated with more ED visits (aIRR 1.5, 95% CI 1.1-2.1).
CONCLUSIONS: For medication knowledge and skills tasks, children of parents who underdosed pain medication had a higher rate of ED visits for pain. Health literate strategies to improve parents' medication skills may improve pain treatment at home and decrease healthcare utilization.
Author List
Morrison AK, Myrvik MP, Brousseau DC, Drendel AL, Scott JP, Visotcky A, Panepinto JAAuthors
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of WisconsinAlexis M. Visotcky Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Anemia, Sickle CellChild
Child, Preschool
Emergency Service, Hospital
Female
Health Literacy
Humans
Infant
Male
Pain
Parents
