Study information | Participants characteristics | Findings | |||||
First author (year) | Setting | Methods | Aim | Age of the recruited sample | Sample size | Health literacy test used | Outcomes and gaps |
Morrison et al
(2017)20 | Outpatient clinic and emergency department | Interviews and applied assessment | To examine the association between parent health literacy and pain medication knowledge and applied skills in parents of children with sickle cell disease. | Parents of children 1–12 years old. | 100 | Newest vital sign (NVS) | Parents with low health literacy made more under dose frequency errors on the pain treatment skills. Health literacy was not associated with errors on the applied treatment skills. Parents recalled underdosing of medication (both dose and frequency). On the applied pain treatment skills, parents made both underdoing and overdosing errors. |
Torres et al (2018)28 | Paediatric outpatient clinics | Cross-sectional analysis | Sought to examine the interrelationships between parents’ preferences and perceptions regarding unites of measurement, parents millilitre dosing experiences, and parent health literacy. | Parents or legal guardian of children≤8 years old. | 493 | NVS | Parents preferred the millilitre dosing to be easy; few 11.5% prefers teaspoon units. Parents will low health literacy levels had a higher odd of having a teaspoon preference and greater odds of perceiving difficulty with the millilitre only dosing. |
Williams et al (2019)27 | Outpatient clinics | Cross-sectional analysis | To assess parent decision‐making regarding dosing tools, a known contributor to medication dosing errors, by evaluating parent dosing tool use, beliefs, and access, and the role of health literacy, with a focus on dosing cups, which are associated with an increased risk of multifold overdose. | Parents or legal guardians of children aged ≤8 years old. | 473 | NVS | Health literacy is one of the factors that could be associated with the dosing tool choice. Parents with limited health literacy reported that dosing cups were the tool used most of the time. |
Yin et al
(2010)16 | Paediatric clinic | Observational | To assess parents’ liquid medication administration errors by dosing instrument type and to examine the degree to which parents’ health literacy influences dosing accuracy. | Parents of children with no specific age limitation. | 302 (287 mothers, 8 fathers, 7 legal guardians) | NVS | Health literacy was significantly related to doing errors with the cups as well as the dosing spoon, while non-significant trend was seen for the dropper and the oral syringes with the bottle adaptor. |
Samuels-Kalow et al
(2013)18 | Tertiary | Prospective observational | To examine language-based disparities in discharge communication and parental understanding of discharge instructions. | Parents of children 2 to 24 months. | 145 | Short Test of Functional Health Literacy (S-TOFHLA) | Parents had acetaminophen dosing errors. There is significant association between language and dosing errors. Parents with marginal or inadequate health literacy had dosing errors compared with adequate health literacy. |
Yin et al
(2014)15 | Paediatric emergency department | Interviews and observations | To examine the degree to which recommended provider-counselling strategies, including advanced communication techniques and dosing instruments provision, are associated with reductions in parents liquid medication dosing errors. | Parents of children aged <8 years old. | 287 | S-TOFHLA | Majority of the patents made underdoing errors as well as few made overdosing errors. Recipient of at least one advanced counselling were less likely to make a dosing error compared with those who did not report received advanced counselling. Parent who received dosing instrument from the emergency department made fewer errors. For adequate health literacy levels was significantly associated with fewer errors when they have received advanced counselling in combination with instrument provision but not the low literacy. |
Yin et al
(2014)19 | Emergency department | Interviews and observations | To examine the association between unit used and parent medication errors and whether non-standard instruments mediate the relationship. | Parents of children aged <9 years old. | 400 | S-TOFHLA | Parents made different kind of error in measurement. One in six parents used kitchen spoon rather than a standard instrument. Parents did not used the unit listed on the prescription or label. |
Yin et al
(2007)17 | Paediatric emergency department. | Interviews | To assess whether low caregiver health literacy was related to risk factors for liquid medication dosing errors, including reported use of non-standardised dosing tools and lack of knowledge about weight-based dosing. | Parents and caregivers of children aged between 30 days to 8 years old. | 292 | Test of Functional Health Literacy in Adults | Low health literacy, particularly reading comprehension, was associated with reported use of non-standardised dosing instruments and lack of knowledge regarding weight-based dosing. In addition, this has been found previously to be associated with decreased dosing accuracy. |