Discharge Medication Counseling in Hospitalized Children

Not Applicable

Completed

Conditions: Medication Management

Interventions: Behavioral: Medication counseling

Registration Number: NCT05143047

Lead Sponsor: Vanderbilt University Medical Center

Brief Summary: Our objective is to design and test the efficacy of a health-literacy-informed discharge medication counseling intervention in the inpatient setting to reduce medication dosing errors and improve adherence in hospitalized children discharged on a new liquid medication.

Detailed Description: The goal of this research is to improve discharge medication adherence and reduce medication dosing errors following pediatric hospitalization. Medication errors are one of the most common healthcare-associated adverse events in pediatrics, with approximately one out-of-hospital medication error occurring every 8 minutes among children \< 6 years of age. Liquid medications account for the majority of pediatric dosing errors which is likely due to liquid medications' inherent dosing complexities, including the need for weight-based dosing, different concentrations of medications, and parental use of unstandardized dosing instruments. The increased stress and exhaustion that many caregivers experience during a hospitalization, coupled with the need to assimilate large amounts of information pertaining to post-discharge care, makes transitioning to home from an inpatient stay a particularly high risk period for medication errors. Communication challenges, particularly failure to consider caregiver health literacy, further compounds the risk for medication errors due to poor caregiver comprehension and adherence to discharge instructions.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 198

Inclusion Criteria

Caregivers of children up to 6 years old who are hospitalized on a general inpatient hospital medicine teams
Caregivers must speak English or Spanish
Participants' children must be discharged home on new scheduled liquid medication for minimum 3 days.

Exclusion Criteria

Medication will be administered by home health nurse
Child is in state/protected custody
Medication prescription is prescribed to pharmacy other than hospital outpatient pharmacy

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention	Medication counseling	Participants in the intervention group will receive supplementary medication discharge instructions in addition to the standard communications. They will receive instructions on how to submit information and complete study surveys securely through their cellphones during their child's home treatment period.

Primary Outcome Measures

Name	Time	Method
Observed Dosing Accuracy	During follow-up survey assessment 48-72 hours following hospital discharge	Participants (caregivers) will be asked to draw up a dose of their child's liquid medication using the provided oral dosing syringe and send a secure picture of the syringe via myCap (secure phone application designed to collect patient-centered outcomes for research studies) to research study staff. The primary outcome will be assessed as a continuous percent difference from the prescribed dose (in milliliters) documented in the electronic health record. Study staff assessing amount in picture are blinded to group assignment.

Secondary Outcome Measures

Name	Time	Method
Correct Medication Dose	During follow-up survey assessment 48-72 hours following hospital discharge	Participants (caregivers) will be asked in a follow-up survey to provide the dosage for their child's discharge medication. This will be scored as correct if it matches the indication for the medication prescribed in the electronic health record.
Correct Medication Frequency	During follow-up survey assessment 48-72 hours following hospital discharge	Participants (caregivers) will be asked in a follow-up survey to provide the frequency of their child's discharge medication. This will be scored as correct if it matches the frequency of the medication prescribed in the electronic health record.
Correct Medication Name	During follow-up survey assessment 48-72 hours following hospital discharge	Participants (caregivers) will be asked in a follow-up survey to provide the name of their child's discharge medication. This will be scored as correct if it matches the name of the medication prescribed in the electronic health record.
Reported Dosing Accuracy	During follow-up survey assessment 48-72 hours following hospital discharge	Participants (caregivers) will be asked to report the prescribed volume (in milliliters) of medication to be given with each dose during the follow-up myCap survey. This will be compared to the prescribed dose in the electronic medical record.
Correct Medication Indication	During follow-up survey assessment 48-72 hours following hospital discharge	Participants (caregivers) will be asked in a follow-up survey to provide the indication for their child's discharge medication. This will be scored as correct if it matches the indication for the medication prescribed in the electronic health record.