A child with a chronic medical condition, such as sickle cell anemia, cancer, or epilepsy, may require several doses of medication per day—a routine that can be tough to keep up with. So tough, in fact, that a new study, presented Monday at the Pediatric Academic Societies annual meeting in Vancouver finds that errors in giving medications to children at home are not uncommon. Researchers identified 128 medication errors—such as giving too much or too little of a drug—during visits to the homes of 83 children between December 2007 and September 2009. Seventy three of those errors had the potential to harm the child, while 10 errors actually caused injury.
"In some homes, we found up to six errors," says lead study author Kathleen Walsh, assistant professor of pediatrics at the University of Massachusetts Medical School. Homes that didn't have a centralized location for medication and those where children were responsible for administering their own medications, with no parental oversight, were more likely to have errors, she says.
But Walsh emphasizes that such mistakes are preventable—if parents take precautions. Here are 8 tips for preventing medication errors:
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Don't rely your memory. Instead, ask your child's doctor for medication instructions in writing, including the proper dosage and time of day to give the medicine. This is especially helpful when more than one adult cares for the child, Walsh says.
Be inquisitive. If you don't understand the doctor's instructions, ask him for clarification. "[Parents] should make sure that they know exactly what they're doing, and the doctor should help with that," Walsh says. There's no room for guesswork.
Get organized. Select an area where you plan to keep all medications, rather than having them scattered throughout the home in different bathrooms, bedrooms, and closets, Walsh advises. Homes that had the fewest medication errors in the study were those in which all medicines were kept in one location, with expiration dates easily accessible.
Use the proper equipment. Ask your child's doctor how best to administer the medicine. He may recommend using a pill splitter, rather than a knife, if a medication needs to be cut apart. Or, he may suggest using a syringe or medicine cup to ensure correct dosing. One warning: If the markings on your syringe or medicine cup wear away, replace the device promptly to guarantee that your child gets the right amount of medicine.
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Make a list. Keep a running tally of your child's medicines along with a notation indicating why the child is taking each drug. Bring this list with you to all doctor's appointments. About two-thirds of the families in the study didn't maintain such a list, and they were more likely to experience medication errors, Walsh says.
Be creative. Some families in the study used cellphone alarms as reminders to take medications, and some used computerized calendars or Excel spreadsheets to monitor dates and times medications were administered. Others used pill containers labeled with the day of the week in order to keep track of a child's medication schedule, but Walsh warns that this method can be risky for young children, since these containers are not childproof.
Don't stop a medication without telling your child's doctor. Some parents stopped giving their children medicines because they didn't like the side effects—drowsiness, for example—but they failed to tell the doctor who prescribed the medicine about their concerns. "Being very honest and clear about what you're doing at home is important because it can affect your child's health," Walsh says. For conditions like cancer, the risk of stopping an essential medication could be deadly.
Don't let your child do it on his own. Even older children and teenagers still need some oversight, Walsh says. Adolescents and teenagers tend to think they're invincible, she says, which is a recipe for problems if that perception tempts them to skip needed doses. In homes visited as part of the study, children as young as 9 were responsible for administering their own medicines, but "what we found is those kids weren't taking their medicine," Walsh says. The takeaway: By the time children become teenagers, they should be in charge of taking their own medicine, but parents should watch closely to make sure they're following instructions. In essence, "trust, but verify," Walsh says.