Perceptions and attitudes of pediatricians and families with regard to pediatric medication errors at home

Medication-related deaths and adverse effects are mainly due to medication errors [1]. Drug safety is particularly important in pediatric patients, as they may be at higher risk of harm resulting from errors than adult patients [2]. Previous studies have uncovered errors at all stages of pediatric medication use, from prescription to administration [3], in the hospital, outpatient and home setting [4].

A 2020 meta-analysis by Gates et al. [4] obtained a rate of medication error in hospitalized children of 15.0 (3.1–49.4) per 100 prescriptions. The authors observed that most medication errors in the hospital setting occurred during prescribing process. In 2019, Glick et al. [5] found that 38% of parents or legal guardians committed some type of error when administering medication to their children in the first two weeks after discharge. Data from the US National Poison Database System showed a mean annual rate of out-of-hospital medication errors in the decade between 2002 and 2012 of 26.42 per 10,000 children aged under 6 years [6]. This should be taken as an approximated value because this system only captures cases reported to poison control center. The medication errors without recognition or errors that were noticed but not reported because individuals involved seek information from other sources were not counted.

Although most studies on pediatric medication errors at home focus on dose errors [5, 7], the literature has shown that parents and/or caregivers also make other mistakes, such as incorrectly preparing or reconstituting the medication [8, 9] or administering the dose twice [6]. Berthe-Aucejo et al. [9] found that among parents and caregivers, risk factors for committing errors when administering medication to pediatric patients included being young, male, and non-native to their country of residence. Higher frequency of errors may also be associated with medical prescriptions that include more than two drugs, and certain types of dosing devices [10]. According to previous studies, analgesics are most commonly involved in pediatric medication errors at home [6, 11].

To reduce the occurrence of these errors, it is necessary to promote the safe use of medication at home. One prevention strategy involves medication error reporting systems [12]; however, as far as we know, no such system exists for the parents or caregivers of pediatric patients [13]. Currently, there is a great deal of interest in how patients and families can report patient safety events and work with policymakers and healthcare professionals to improve patient safety. In fact, in the United States, as well as in other countries such as Finland and Norway, there are initiatives to create independent agencies that can receive reports on adverse events in patient safety, analyze data, identify patterns of harm risks, investigate, and establish prevention and recommendation strategies to prevent adverse events in the home, with a particular focus on medication errors. This study aims to provide a preliminary understanding of the challenges faced by caregivers of pediatric patients in home care, with a specific focus on medication errors, and to identify potential strategies to prevent and minimize them. The goal is to learn from these experiences and prevent future occurrences of such errors. These and other prevention programs should be based on the needs of the users, i.e. pediatricians and parents or caregivers. Thus, the research question was: what are the perceptions and attitudes of pediatricians and families towards pediatric medication errors at home? This study aims to identify and compare the perceptions and attitudes of pediatricians and those of parents/caregivers regarding pediatric medication errors at home.