Promoting public health online: Children’s medication

Giving medicine to children can be challenging – as Dr Justin Coleman, Chair of the RACGP working group on the Choosing Wisely Australia campaign, knows only too well.
 
‘It takes a bit more preparation, because the dosage precision has to be more accurate compared to adults – for most adults, there’s a one-size-fits-all approach, whereas that doesn’t work in children,’ he said.
 
‘The second thing is the capacity or willingness of the child to take medication, unlike adults who tend to know what’s good for them, even if they don’t like it.
 
‘Hence we have liquid medications instead of tablets, usually, and the recipient isn’t necessarily cooperative – with children, you often have a moving target.’
 
As a result of such challenges, NPS MedicineWise, the national public health promotion organisation, found it was receiving a high volume of social media posts from parents looking for advice about administering medicine to children.
 
‘Among questions such as how much of the medicine to give, how to encourage the child to take the medicine, and where to safely store it, we have also heard questions like “Can I mix this medicine with juice or yogurt” and “Can I bake it into a cupcake?”,’ NPS MedicineWise spokesperson and pharmacist Sarah Spagnardi said.
 
While it is positive these questions are being asked of a public health organisation that can provide evidence-based answers, Dr Coleman is aware this is not always the case – and that many other parents will be turning elsewhere.
 
‘If you look at social media and mum’s groups, there’s a lot of discussion about what medication to give and how to take medication and whether kids should even have medication,’ he said. ‘And so that discussion is rife [about children’s medication], compared to adult medical sites, where the active taking of medication isn’t nearly of as much interest.’
 
However, Dr Coleman acknowledges that parental anxiety around the issue of children’s medication is understandable, given the potential consequences of mistakes.
 
‘The safety ranges of the dose are often narrower in children, so you can do more harm inadvertently; adults are generally more robust,’ he said. ‘So parents do have a concern that they’re getting it right.’
 
Dr James Best, Chair of the RACGP Child and Young Person’s Health Specific Interests network, told newsGP that in some jurisdictions, these concerns have led to calls for additional governmental oversight.
 
‘There has been some push, in certain countries, to have increased regulation of what information the prescriber provides the dispenser, such as the age and the weight of the child, and specifying not only the quantity, but also the volume of the liquid,’ he said.
 
‘So this is an area that is well-recognised as having an increased level of difficulty and risk of adverse outcomes.’
 
To help combat this problem, NPS MedicineWise has, in partnership with the Sydney Children’s Hospital Network, created a series of videos addressing their most frequently-asked questions around the issue with advice from healthcare professionals.
 
‘Busy parents and carers need good, evidence-based advice, and they need it fast, so these three quick videos feature practical tips from a nurse, a child life therapist and a pharmacist to help parents and carers keep their children safe and healthy,’ Ms Spagnardi said.
 
Dr Coleman believes these videos represent a good strategy to get important healthcare information directly to the target audience.
 
‘Traditionally, large organisations like hospitals and authoritative collections of doctors tended to give rather highbrow, detailed information, like putting out an explanatory one-pager on something or detailed notes on medication,’ he said. ‘But unfortunately, that is not the conversation the majority of people are having.
 
‘I think it’s really important for organisations that have something worthwhile to say to tap into the modern zeitgeist, which is something short and sharp and packed with interesting little snippets, to drive home a couple of key messages just in one minute.’
 
Dr Coleman hopes these videos will reach their intended targets through sharing on social media platforms and help to counter some of the less well-informed information available on the internet.
 
‘People will share content, and every successful video that gets shared thousands or tens of thousands of times has helped combat some of the more questionable videos that people put up as well,’ he said.
 
‘It’s great to get some evidence-based content out there to compete in the sea of less evidence-based content.’
 
Meanwhile, Dr Best is simply pleased to see a useful and informative tool that can provide assistance for parents and their children.
 
‘Any support parents can get that helps reduce the risk of adverse outcomes in prescribing is a good thing,’ he said.

Child and young person’s health Children’s medication Medication advice Medicine misadventure Medicine poisoning NPS MedicineWise Prescribing Prescribing for children