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Parents want better info on children’s adverse drug reactions

Clarity and timing of doctors’ explanations of ADRs almost always poor

Louise Prime

Thursday, 11 October 2012

Parents want more information about the significance and consequences of adverse drug reactions that their children are suspected to have suffered, UK research has found. Authors of the study, published online in this week’s PLoS ONE, suggest that clinicians need to consider the timing and clarity of their communication with parents about ADRs.

Researchers led from the University of Liverpool conducted semi-structured qualitative interviews, either face to face or by telephone, with the parents of 44 children who had had a suspected ADR identified on hospital admission.

Most of these parents said they were dissatisfied, in terms of both clarity and timing, with how clinicians had communicated with them about the risk of their child suffering an ADR related to a medicine they were to be given. Parents explained that information was often delivered at times when they found it hard to absorb, for example when their child was critically unwell, or about to have a general anaesthetic.

Parents were almost universally critical about ADR management and communication when their child had become ill after using a medicine. The researchers write: “[Parents] reported communication as being contradictory and poorly coordinated, with some clinicians attributing the child’s symptoms to a medicine, while other clinicians attributed the same symptoms to different causes.” Parents also said they felt that GPs had been dismissive of their concerns that their child’s symptoms could be medicine-related.

Parents reported feeling unclear about the implications of a suspected ADR for their children’s health care in future. Some parents said that they had refused the use of further medicines because they were worried that their child would suffer another ADR.

The authors said: “As well as being a source of avoidable parental distress, poor clinician-parent communication about suspected ADRs may challenge parents’ confidence in medicines and contribute to negative perceptions and misunderstandings of medicines [which] could lead to poor adherence in future.”

In contrast, the parents of children with cancer said they felt very confident in clinicians’ management of ADRs. They also said they appreciated how clinicians had explained prospectively the risks associated with their children’s medicines, and carefully paced and timed those conversations.

The authors pointed out that there are currently few guidelines to help clinicians communicate with families about side effects of drugs prescribed to children, which is likely to create confusion for parents of sick children who suffer adverse drug reactions. They concluded: “Our findings will help guide clinicians regarding what topics to cover in their discussions with families about medicines and ADRs.

“At the time of prescription, parents wanted to know the potential risks associated with medicines. In the aftermath of a suspected ADR, they wanted to understand what had happened to their child and in some cases this might include explicit acknowledgment that an ADR had possibly occurred.

“Parents also wanted know the potential future implications of the suspected ADR for their child … our study’s most important contribution may lie in providing insight for clinicians into how valuable discussions of ADRs can be for parents.”

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