Pictogram-based instructions reduce home medication errors among pediatric caregivers: A randomized controlled trial.
Background: Medication errors with liquid pediatric formulations are a pressing patient safety concern. This study evaluated the effectiveness of a pictogram-based instruction package in reducing home medication errors made by caregivers compared with a text-based instruction label. Methods: This ra...
| Published in: | Journal of Patient Safety & Risk Management Vol. 31; no. 4; pp. 182 - 190 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts randomized controlled trial Journal Article |
| Published: |
Sage Publications Inc.
Jul2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196473507&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196473507 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25160435 LAW1 jtl: Journal of Patient Safety & Risk Management issn: 25160435 maglogo: N pubinfo: dt: Jul2026 vid: 31 iid: 4 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 196473507 193107055 196473507 196473507 10.1177/25160435261438711 196473507 ppf: 182 ppct: 8 formats: tig: atl: Pictogram-based instructions reduce home medication errors among pediatric caregivers: A randomized controlled trial. aug: au: Ong, Bee Yean Hoo, Huei Yen binti Borham, Nurul Shafiqah Mohd Salleh, Nur Suhailah binti Mohamed Saat, Sakinah binti Panirselvam, Shalini affil: Department of Pharmacy, Hospital Enche' Besar Hajjah Khalsom, Kluang, Johor, Malaysia sug: subj: Medication Errors Prevention and Control Caregivers Education Drug Labeling Home Health Care Pediatrics Outcomes (Health Care) Malaysia Human Male Female Infant Adult Hospitals, Pediatric Randomized Controlled Trials Random Assignment Pretest-Posttest Control Group Design Comparative Studies Convenience Sample Antibiotics Self Report Pearson's Correlation Coefficient Chi Square Test T-Tests Mann-Whitney U Test Confidence Intervals Odds Ratio Data Analysis Software Descriptive Statistics Patient Preference Patient Safety Infant: 1-23 months Adult: 19-44 years Male Female ab: Background: Medication errors with liquid pediatric formulations are a pressing patient safety concern. This study evaluated the effectiveness of a pictogram-based instruction package in reducing home medication errors made by caregivers compared with a text-based instruction label. Methods: This randomized controlled trial (RCT) recruited 134 caregivers of children prescribed reconstitutable oral antibiotics using convenience sampling. Participants were randomly assigned to receive either pictogram-based instructions (intervention group) or standard text-only labels with verbal explanation (control group). Drug reconstitution errors were directly observed, while potential administration errors were self-reported. Caregiver label preferences were also evaluated. Outcomes between the groups were compared using Chi-square tests, and risk ratios (RR) were calculated to determine the intervention's effect size. Results: The pictogram-based intervention led to a significant reduction in medication errors. The intervention group (n = 69) had substantially fewer reconstitution errors compared to the control group (n = 65) (21.7% vs. 84.6%; risk ratios (RR) = 0.26, 95% confidence interval (CI): 0.16–0.41, p < 0.001) and fewer self-reported potential administration errors (8.7% vs. 84.6%; RR = 0.10, 95% CI: 0.05–0.22, p < 0.001). Notably, errors related to incorrect water volume and misinterpreted dosing intervals and duration were significantly reduced. Over 92% of caregivers in both groups expressed a strong preference for instructions combining pictograms with text, citing improved clarity and ease of understanding. Conclusion: In this RCT, a pictogram-based instruction package was a highly effective and simple risk management tool that significantly reduced caregiver medication errors. Its implementation is a promising strategy to enhance medication safety and adherence in diverse pediatric populations. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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