531 - Frequency of Medication Errors and the Impact of Discharge Education Among Families with Non-English Language Preference

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 531
Publication Number: 531.117

Hadley M. Brighton, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Alexandra Lieberman, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States; Jose Antonio. Gonzalez, Columbia University, Brooklyn, NY, United States; Charlene Thomas, Weill Cornell Medicine, New York, NY, United States; Sumeet Banker, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States

Presenting Author(s)

Hadley M. Brighton, MD (she/her/hers)

Pediatric Hospital Medicine Fellow
NewYork-Presbyterian
New York, New York, United States

Background: Medication errors are common following hospital discharge and Spanish speaking caregivers are at increased risk. Health literacy informed “advanced counseling” techniques such as demonstration, teachback and showback have been shown to reduce caregiver dosing errors and improve understanding of medication instructions, though their effect on medication errors after pediatric hospital discharge has not been investigated.

Objective: To determine the frequency of medication-related errors among English- and Spanish-speaking parents after pediatric hospital discharge and identify whether the use of advanced counseling is associated with decreased medication errors after discharge.

Design/Methods: We performed a prospective cohort study of English- and Spanish-speaking caregivers of children < 18 years old prescribed a new oral daily medication after hospital discharge from March- November 2022. Participants were recruited from an academic tertiary children’s hospital and a community-based hospital. Eligible participants were contacted by phone within four days of discharge and surveyed about management of their children’s medication and elements of discharge education, including use of teach-back and showback. Participants also completed a 4-item validated health literacy assessment (BRIEF). Spanish-speaking participants were surveyed by bilingual investigators. Bivariate analysis compared subject/visit-level factors and discharge processes with medication errors.

Results: A total of 96 caregivers were surveyed, 34 with a primary language of Spanish and 62 English. Liquid medications (86%) and antibiotics (78%) were prescribed most commonly. There were no significant demographic differences between language groups apart from caregiver’s ethnicity (p=< 0.001) (Table 1). Overall, 23 medication errors were identified, including 14 dosing errors. 27% of Spanish-speaking families made dosing errors compared to 8.6% of English speaking families (p=0.032). There were no significant differences in errors between groups with respect to medication start date, frequency of administration or duration (Table 2). There were no significant differences in medication errors based on receipt of advanced counseling techniques (Table 3).

Conclusion(s):
Dosing errors were more common among Spanish speaking caregivers after hospital discharge. Advanced counseling techniques did not impact medication errors. Future studies should investigate optimal ways of counseling about discharge medications and standardizing discharge education, particularly for families with a primary language other than English.