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Published on: November 9, 2016
Using pictograms to assist caregivers in liquid medication administration: a systematic review
H K Chan1, M A Hassali, C J Lim
1Department of Pharmacy, Hospital Sultanah Bahiyah, Kedah, Malaysia.
Insights
Pictorial aids may improve medication safety for children by reducing dosing errors and enhancing caregiver understanding of liquid medication instructions. Further research is needed to confirm their effectiveness in clinical settings.
Area of Science:
- Pediatric pharmacology
- Health communication
- Patient safety
Background:
- Over 80% of out-of-hospital medication errors in young children involve liquid formulations.
- The role of pictorial aids in improving medication instruction comprehension for pediatric care is under-researched.
Purpose of the Study:
- To evaluate the effectiveness of pictorial aids in assisting caregivers with liquid medication administration.
- To determine if pictorial aids improve dosing accuracy, instruction comprehension, recall, and adherence.
Main Methods:
- A systematic literature search was conducted across multiple databases (MEDLINE, CINAHL, PsycINFO, etc.) up to February 2015.
- Included studies assessed pictorial aids for liquid medications and measured outcomes like dosing accuracy and caregiver adherence.
- Methodological quality was assessed using the Cochrane Collaboration's tool by two independent reviewers.
Main Results:
- Five experimental studies involving 962 participants were included.
- Pictorial interventions demonstrated a reduction in dosing errors and enhanced comprehension and recall of medication instructions.
- Combined use of pictorial aids with verbal or text instructions proved more beneficial than single approaches.
Conclusions:
- Pictorial aids show promise in improving medication safety and adherence for children.
- The current evidence is limited by the small number of studies and methodological variations.
- More high-quality research is recommended to support the routine clinical use of pictogram-based materials for liquid medications.
What Is Known And Objective:
It has been reported that more than 80% of out-of-hospital medication errors among the young children involve liquid formulations. The usefulness of pictorial aids to improve communication of medication instructions has not been extensively investigated for child health. The objective of this study was to determine the effectiveness of pictorial aids used to assist caregivers in the administration of liquid medications.
Methods:
MEDLINE, CINAHL, PsycINFO, ScienceDirect, Scopus and the Cochrane Library were searched for articles published up to February 2015. Studies that used pictorial aids with liquid medications and measured at least one of the following outcomes were included: dosing accuracy, comprehension of medication instructions, recall of information and adherence of caregivers. Two authors independently selected studies, extracted data and assessed methodological quality of studies using the Cochrane Collaboration's tool.
Results And Discussion:
Five experimental studies (four hospital based and one community based) with a total of 962 participants were included. A wide range of liquid formulations were studied, including both prescription and over-the-counter medications. The existing findings suggest that pictographic interventions reduced dosing errors, enhanced comprehension and recall of medication instructions and improved adherence of caregivers. Incorporating pictorial aids into verbal medication counselling or text-based instructions was more beneficial than using the single approach alone. Mixed results were identified for the relationship between health literacy of caregivers and effectiveness of pictorial aids.
What Is New And Conclusion:
The evidence remains limited due to the small number of studies found and variations in methodological quality. This review suggests that pictorial aids might be potential interventions, but more high-quality studies are needed to support the routine use of any pictogram-based materials with liquid medications in the clinical settings.
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