TY - JOUR
T1 - Influence of parental health literacy and dosing responsibility on pediatric glaucoma medication adherence
AU - Freedman, Rebecca B.
AU - Jones, Sarah K.
AU - Lin, Alice
AU - Robin, Alan L.
AU - Muir, Kelly W.
PY - 2012/3
Y1 - 2012/3
N2 - Objective: To assess glaucoma medication adherence in children, hypothesizing that poor parental health literacy and eye drop instillation by the child are associated with worse adherence. Methods: This prospective, observational study enrolled pediatric patients with glaucoma who were prescribed eye drops. Parent(s) reported who was responsible for eye drop instillation (parent vs child), took the Rapid Estimate of Adult Literacy in Medicine, and were instructed on the use and purpose of the Medication Event Monitoring System. Calculations included average adherence (proportion of prescribed doses taken), dosing errors (number of overdosing or underdosing events in 24 hours), and proportion of doses taken on schedule (doses taken within2 hours of prescribed dosing interval). Results are reported as mean (SD) or median. Results: The study included 46 of the 50 enrolled children who used the Medication Event Monitoring System for 30 days or more. Adherence ranged from 43% to 107% (93%[12%]) and was not associated with age (slope, 0.09 [0.52]; P=.86) but decreased with the parent's lower health literacy (slope, 0.62 [0.24]; P=.01).The mean number of dosing errors for medications prescribed daily vs twice daily was similar (3.3 vs 2.9; P=.66). The proportion of doses taken on schedule (within2hours of prescribed dosing interval) ranged from 3% to 97% (median, 34%; mean, 41%[24%]) and was better when the parent vs the child instilled eye drops (46% [26%] vs 23% [19%]; P <.001). Conclusions: Time-dependent glaucoma medication adherence was better when the parent was responsible for eye drop instillation. Overall decreased adherence was associated with decreased parental health literacy. Children of parents with poor health literacy are vulnerable to poor medication adherence; efforts to address poor health literacy may improve outcomes.
AB - Objective: To assess glaucoma medication adherence in children, hypothesizing that poor parental health literacy and eye drop instillation by the child are associated with worse adherence. Methods: This prospective, observational study enrolled pediatric patients with glaucoma who were prescribed eye drops. Parent(s) reported who was responsible for eye drop instillation (parent vs child), took the Rapid Estimate of Adult Literacy in Medicine, and were instructed on the use and purpose of the Medication Event Monitoring System. Calculations included average adherence (proportion of prescribed doses taken), dosing errors (number of overdosing or underdosing events in 24 hours), and proportion of doses taken on schedule (doses taken within2 hours of prescribed dosing interval). Results are reported as mean (SD) or median. Results: The study included 46 of the 50 enrolled children who used the Medication Event Monitoring System for 30 days or more. Adherence ranged from 43% to 107% (93%[12%]) and was not associated with age (slope, 0.09 [0.52]; P=.86) but decreased with the parent's lower health literacy (slope, 0.62 [0.24]; P=.01).The mean number of dosing errors for medications prescribed daily vs twice daily was similar (3.3 vs 2.9; P=.66). The proportion of doses taken on schedule (within2hours of prescribed dosing interval) ranged from 3% to 97% (median, 34%; mean, 41%[24%]) and was better when the parent vs the child instilled eye drops (46% [26%] vs 23% [19%]; P <.001). Conclusions: Time-dependent glaucoma medication adherence was better when the parent was responsible for eye drop instillation. Overall decreased adherence was associated with decreased parental health literacy. Children of parents with poor health literacy are vulnerable to poor medication adherence; efforts to address poor health literacy may improve outcomes.
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U2 - 10.1001/archopthalmol.2011.1788
DO - 10.1001/archopthalmol.2011.1788
M3 - Article
C2 - 22411659
AN - SCOPUS:84858607784
SN - 0003-9950
VL - 130
SP - 303
EP - 311
JO - Archives of ophthalmology
JF - Archives of ophthalmology
IS - 3
ER -