Exploring caregiver understanding of medications immediately after a pediatric primary care visit

ObjectiveAssess accuracy of caregiver understanding of children's prescribed medications and examine factors associated with accurate recall.MethodsCross-sectional, observational study of English- or Spanish-speaking caregivers of primary care patients aged 0-7 years. Child and visit characteristics and caregiver health literacy (Short Test of Health Literacy in Adults) were assessed. Post-visit, caregivers completed questionnaires on medications prescribed. Caregiver and medical record agreement on medication name and administration (dose and frequency) were examined using chi square and logistic regression.ResultsAnalyses included 68 caregivers (28% low health literacy); 96% of children had public insurance. Caregivers indicated that the doctor provided clear medication information (100%) and they could follow instructions (98%). 101 medicines were prescribed; 6 were recalled by caregiver only. 71% of medications were accurately named; 37% of administration instructions were accurately recalled. Accurate naming was more often found for patients 3-7 years, without conditions requiring repeat visits, and new medications. Accurate administration responses were associated with having only 1 child at the visit.ConclusionUnperceived medication instruction understanding gaps exist at physician visits for caregivers of all literacy levels. Communication and care delivery practices need further evaluation.Practice implicationsClinicians should be aware of the frequency of caregiver medication misunderstanding.