Parents' pain medication underdosing is associated with more emergency department visits in sickle cell disease.

Authors

• Andrea K Morrison
• Matthew P Myrvik
• David C Brousseau
• Amy L Drendel
• J Paul Scott
• Alexis Visotcky
• Julie A Panepinto

Publication/Presentation Date

4-1-2018

Abstract

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.

Volume

65

Issue

4

ISSN

1545-5017

Published In/Presented At

Morrison, A. K., Myrvik, M. P., Brousseau, D. C., Drendel, A. L., Scott, J. P., Visotcky, A., & Panepinto, J. A. (2018). Parents' pain medication underdosing is associated with more emergency department visits in sickle cell disease. Pediatric blood & cancer, 65(4), 10.1002/pbc.26906. https://doi.org/10.1002/pbc.26906

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

29230919

Department(s)

Administration and Leadership

Document Type

Article