title: Administration of anticonvulsive rescue medication in children-discrepancies between parents' self-reports and limited practical performance.
abstract: Quality of parents' performance in administering anticonvulsive rescue medication to their children suffering from seizures is unknown. After obtaining ethical approval, we used a questionnaire to ask parents of children with seizures, who had been prescribed rescue medications, about their experience in administering those. To assess the frequency of actually committed drug-handling errors, we let them administer rescue medications to dummy dolls. An expert panel rated the clinical risk of handling errors from "1" (lowest) to "6" (highest). Eighty-one parents completed the study. In the questionnaire, 85 % (100 %) of parents that already conducted rectal (buccal) administration reported that they had never experienced problems. The number of rectal administrations with at least one handling error (97 %, 58/60) was higher than in buccal administration (58 %; 14/24; p < 0.001). According to logistic regressions, previous use of rescue medication was not a predictor of the number of committed errors per process (n. s.). All errors were rated with a high clinical risk (class 4-6).
  
  
  CONCLUSIONS
  By observing parents' administration of rescue medication to dummy dolls, we found a high frequency of clinically relevant drug-handling errors. Most parents, however, self-reported to have never experienced problems while administering rescue medications to their children.
  
  
  BACKGROUND
  • For seizures with duration of more than 5 min, the administration of anticonvulsive rescue medication is recommended. • Outside the hospital, the administration of rescue medication to children is performed most frequently by their parents. What is New: • Most of the parents reported that they had never experienced problems in handling anticonvulsive rescue medication. • But in the observed drug-handling performances, identified errors committed by parents were alarmingly frequent and pose a high clinical risk according to an expert panel.
authors.affiliation: Drug Safety Center, Leipzig University and University Hospital of Leipzig, Eilenburger Str. 15a, 04317, Leipzig, Germany.|Department of Clinical Pharmacy, Leipzig University, Eilenburger Str. 15a, 04317, Leipzig, Germany.
authors.forename: Almuth
authors.initials: A
authors.lastname: Kaune
authors.affiliation: Drug Safety Center, Leipzig University and University Hospital of Leipzig, Eilenburger Str. 15a, 04317, Leipzig, Germany.|Department of Clinical Pharmacy, Leipzig University, Eilenburger Str. 15a, 04317, Leipzig, Germany.
authors.forename: Pia Madeleine
authors.initials: PM
authors.lastname: Schumacher
authors.affiliation: Drug Safety Center, Leipzig University and University Hospital of Leipzig, Eilenburger Str. 15a, 04317, Leipzig, Germany.|Department of Clinical Pharmacy, Leipzig University, Eilenburger Str. 15a, 04317, Leipzig, Germany.
authors.forename: Sabine Christine
authors.initials: SC
authors.lastname: Hoppe
authors.affiliation: Department of Women and Child Health, Hospital for Children and Adolescents, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.|Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.|Department of General Paediatrics, Division of Child Neurology and Inherited Metabolic Diseases, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Syrbe
authors.affiliation: Department of Women and Child Health, Hospital for Children and Adolescents, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.|Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
authors.forename: Matthias Karl
authors.initials: MK
authors.lastname: Bernhard
authors.affiliation: Drug Safety Center, Leipzig University and University Hospital of Leipzig, Eilenburger Str. 15a, 04317, Leipzig, Germany.|Pharmacy Department of the University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Roberto
authors.initials: R
authors.lastname: Frontini
authors.affiliation: Department of Women and Child Health, Hospital for Children and Adolescents, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.|Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Merkenschlager
authors.affiliation: Department of Women and Child Health, Hospital for Children and Adolescents, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.|Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
authors.forename: Wieland
authors.initials: W
authors.lastname: Kiess
authors.affiliation: Drug Safety Center, Leipzig University and University Hospital of Leipzig, Eilenburger Str. 15a, 04317, Leipzig, Germany.|Department of Clinical Pharmacy, Leipzig University, Eilenburger Str. 15a, 04317, Leipzig, Germany.
authors.forename: Martina Patrizia
authors.initials: MP
authors.lastname: Neininger
authors.affiliation: Department of Women and Child Health, Hospital for Children and Adolescents, University Hospital Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.|Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Bertsche
authors.affiliation: Drug Safety Center, Leipzig University and University Hospital of Leipzig, Eilenburger Str. 15a, 04317, Leipzig, Germany. thilo.bertsche@medizin.uni-leipzig.de.|Department of Clinical Pharmacy, Leipzig University, Eilenburger Str. 15a, 04317, Leipzig, Germany. thilo.bertsche@medizin.uni-leipzig.de.
authors.forename: Thilo
authors.initials: T
authors.lastname: Bertsche
mesh_terms: D000278:Administration, Buccal; D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage*; D002648:Child; D003975:Diazepam / Q000008:administration & dosage; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D010290:Parents; D012306:Risk; D016879:Salvage Therapy / Q000706:statistics & numerical data; D012640:Seizures / Q000188:drug therapy*; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D003975:Diazepam; D008874:Midazolam
keywords: Anticonvulsants; Handling errors; Rescue medication