Abstract
Background Children with cancer take complex life-saving chemotherapy regimens, many of which are administered at home by their parents. Our research indicates that errors in home medication use are common among children with cancer. In home visits, we found that the use of support tools significantly reduced the risk of errors.
Method We developed a web-based Home Medication Support intervention (HoMeS). The intervention development process steps were: convene work group, consult parent advisors, develop paper mock-ups, web-based development, and test-retest cycles.
Results Our work group consists of a pediatric oncologist, patient safety expert, cancer communication expert, and health information technology expert. We also consulted with four parents of children with cancer who were undergoing or recently completed home oral chemotherapy treatment. Parents identified needed improvements to a printed calendar which they received often, but not always, from their oncologist. Improvements included: check boxes to record when a dose was given, generic and brand names, metric conversion, and dosing support. Pediatric oncologists requested a computer program to create and save the medication calendar which they could save for each patient from month to month. We developed a paper mock up of a patient-specific monthly Home Medication Support (HoMeS) calendar, with both generic and brand names for each of the child’s medications (e.g., meperidine = Demerol), abbreviations and generic names (e.g., 6-MP = 6-mercaptopurine), and dosing support. To prevent errors, we included color coded medication names, included check boxes for recording medication administration at home to support parent to parent communication, descriptions of how to prepare the medicine, and dosages for all as needed medicines, including pain medication. We are currently testing the HoMeS calendar, and developing supplemental educational tools to enhance parent understanding of cancer treatment. By spring 2011, we will implement and evaluate HoMeS using time-series methods.
Conclusions Parents and oncologists requested improvement in the home medication calendar to increase usability and prevent errors in home medication use among children with cancer. We developed a Home Medication Support (HoMeS) intervention and will be enhancing, implementing, and pilot testing this intervention to support communication and prevent errors.
