777 - Parent Dosing of Acetaminophen, Ibuprofen and Diphenhydramine

Poster Number: 777
Publication Number: 777.148

Karina Phang, Geisinger Janet Weis Children's Hospital, Geisinger Commonwealth School of Medicine, Clarks Summit, PA, United States; Jennifer Vodzak, Geisinger Janet Weis Children's Hospital | Geisinger Commonwealth SOM, Danville, PA, United States

Background: Over the counter pediatric medications, such as acetaminophen, ibuprofen, and diphenhydramine, are widely used and are perceived to be safe by parents. Dosing errors of these medications may lead to unintended toxicity or inadequate symptomatic improvement. Dosing errors of these medications among parents has not been studied in a large integrated health system serving predominantly rural and suburban children. There is limited research understanding the relationship of multiple formulations of liquid ibuprofen and liquid ibuprofen dosing errors by parents in the outpatient setting.

Objective: The study objectives were to: 1) Evaluate parent dosing accuracy of acetaminophen, ibuprofen and diphenhydramine 2) Identify parental characteristics associated with incorrect dosing and 3) Explore if caregivers find ibuprofen concentrations confusing 

Design/Methods: This study is a cross sectional analysis of parents or caregivers of patients ages 6 months to 8 years of age in 3 pediatric clinics. The parents or caregivers (n=203) had to identify as one of the main individuals who administer medications to the child. Interviews occurred after an in office pediatric clinic visit with a weight taken that day. Caregivers participated in a 30-minute interview with observed dosing assessments. Caregivers were randomized into 1 of 6 groups to vary the order in which the parent dosed acetaminophen, ibuprofen and diphenhydramine for their child. Caregivers then were provided with an ibuprofen concentration scenario for a hypothetical child in which they have only one type of liquid ibuprofen formulation available. Lastly, health literacy assessment (The Newest Vital Sign) and demographic information of the parent and child were obtained. Dosing errors were defined as an error with >20% deviation of the recommended dose.

Results: We found that 34% of parents made ≥1 dosing error when giving a dose of acetaminophen, ibuprofen, or diphenhydramine for their child. P</span>arents of children less than 2 years old were more likely to make medication dosing errors (p < 0.001). Parents with low health literacy were more likely to make medication dosing errors (p < 0.001). We found that 22% of parents made dosing errors with liquid ibuprofen in the ibuprofen concentration scenario.  

Conclusion(s): Dosing errors with acetaminophen, ibuprofen, and diphenhydramine are common in rural and suburban pediatric parents.