Over-the-counter medications. Do parents give what they intend to give?
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.


METHODS
Prospective patient series.


METHODS
A tertiary care pediatric emergency center.


METHODS
A representative sample of children with nonemergent chief complaints.


METHODS
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.
Simon
H K
HK
Department of Pediatrics, Egleston Children's Hospital, Emory University School of Medicine, Atlanta, Ga., USA. hsimon@emory.edu
Weinkle
D A
DA
D000082:Acetaminophen / Q000008:administration & dosage; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D002648:Child; D005260:Female; D005334:Fever / Q000188:drug therapy; D006266:Health Education; D006801:Humans; D008297:Male; D008508:Medication Errors; D004366:Nonprescription Drugs / Q000008:administration & dosage*; D010290:Parents
D018712:Analgesics, Non-Narcotic; D004366:Nonprescription Drugs; D000082:Acetaminophen