Medication Safety at HomeKey findings from a parent focus group

Stephen Morris

Clinical Pharmacist / NIHR ICA Pre-doctoral Clinical Academic Fellow

SPS Webinar – December 2019

FundingStephen Morris is funded by a National Institute for Health Research (NIHR), Integrated Clinical Academic Pre-Doctoral Fellowship for this research project.

Patient and public involvement was funded through the NIHR Research Design Service Yorkshire and Humber Public Involvement Fund.

Welcome to Leeds!

2Image taken by Author.

3Image taken by Author.

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Image from google.com (under creative commons license). Full reference list at end of presentation. Top left[1,2], top right [3,4], bottom [5,6]

Engaging Families - Recruitment

5Author has permission for image use.

Engaging Families - Focus Group

6Image taken by Author with permission to re-use

What did families tell us?

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I was standing in the pharmacy, and they said “we can’t get hold of this sodium

chloride liquid”. I was exhausted, I said, “it’s just

salt isn’t it? Just tell me how much to put in some water

and I’ll make it myself.

Whilst in hospital, there is always a

feeding tube, so there is never a thought

about how to administer at home

without one.

I have a serious nut allergy. No one

told me my son’s multivitamin

contained peanut oil.

When I went home, I didn’t feel like I was a

parent. I felt like the nurse or

carer of my baby

Key MessagesTheme What we can do for families? How do we do that?

Having a young baby at home is exhausting

Make things as easy as possibleRound dosesConvenient administration timesStop unnecessary medicines

Save parents timeGood supplies of medicines at transferBetter communication between HCPsUse of standard formulations

Getting a child to take a medicine is hard

Have conversations about practicalities of dosing

Using appropriate dose volumesMissed dosesHow to mix medicines with food

Encourage use of age appropriate formulationsProvide support with tablet swallowing trainingWorking with industry/pharmaceuticals

Have conversations about where to go for information

Signpost to medicines for childrenListen to concerns and questions

Keeping records is hard Support parents to keep good records

Use technologySignpost to medicines for childrenProvide MARS chartAccurate healthcare documentation (e.g. discharge)

Caring for a sick child is isolating

Expand the network of support available to parents

Signpost to support networksTrain wider family (e.g. grandparents)

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Medicines for Children

9Image from www.medicinesofchildren.org.uk

10Author has permission for image use.

11Author has permission for image use.

References

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1. Walsh, K.E., et al. Medication errors in the home: a multisite study of children with cancer. Pediatrics. 2013, 131(5), pp.1098-4275

2. Solanki, R., et al. Medication errors by caregivers at home in neonates discharged from the neonatal intensive care unit. Archives of Disease in Childhood. 2017, 102(7), p.651.

3. Crawford, C., et al. Overdose in young children treated with anti-reflux medications: Poisons enquiry evidence of excess 10-fold dosing errors with ranitidine. Hum Exp Toxicol. 2018, 37(4), pp.343-349.

4. Gallagher, R., et al.. Adverse drug reactions causing admission to a paediatric hospital. PLoS One. 2012.

5. Bergene, E.H., et al. Strategies parents use to give children oral medicine: a qualitative study of online discussion forums. Scandinavian journal of primary health care. 2017, 35(2), pp.221-228.

6. Aston, J., et al. The treatment-related experiences of parents, children and young people with regular prescribed medication. International Journal of Clinical Pharmacy. 2019, 41(1), pp.113-121.

Contact DetailsEmail: Stephen.morris1@nhs.net

Twitter: @sjm_85 @LeedsNERDs