Aim: Due to a lack of age-appropriate formulations, administration of drugs to children remains a challenge. This study aimed to identify the problems experienced in both the outpatient setting and the clinical setting. Methods: Between June 2017 and January 2018, we performed a cross-sectional, prospective study at the Sophia Children’s Hospital, The Netherlands. The study comprised of a structured interview on drug manipulations with parents visiting the outpatient clinic, and an observational study of drug manipulations by nurses at the wards. Results: A total of 201 questionnaires were collected, accounting for 571 drugs and 169 manipulations (30%). Drug substances that were most often mentioned as manipulated were macrogol (n = 23), esomeprazole (n = 15), paracetamol (n = 8), methylphenidate (n = 7) and melatonin (n = 7). Of all manipulated medicines, 93/169 (55%) were manipulated according to the instructions or recommendations of the Summary of Product Characteristics (SmPC) or patient information leaflet. During the observational study, manipulation was performed by 21/35 of observed nurses (60%), of whom 11 deviated from the hospital protocol for manipulation or SmPC (52%). Conclusion: Manipulation was a widely used method to administer drugs to children. Validated information regarding manipulation of drugs for both parents and nursing staff is needed.

Additional Metadata
Keywords Compliance, Drug administration, Oral medication, Paediatric medicines, Paediatric nursing
Persistent URL dx.doi.org/10.1111/apa.14718, hdl.handle.net/1765/118818
Journal Acta Paediatrica: promoting child health
Citation
Vossen, A.C.Th.M, Al-Hassany, L., Buljac, S., Brugma, JD, Vulto, A.G, & Hanff, L.M. (2019). Manipulation of oral medication for children by parents and nurses occurs frequently and is often not supported by instructions. Acta Paediatrica: promoting child health, 108(8), 1475–1481. doi:10.1111/apa.14718