Opportunities and Ideas to Make a Difference With Pediatric Patients
Educating patients can be especially rewarding with children.
Part of what pharmacists do for patients is educate them, and this can be especially rewarding and important when the patients are children. Children account for 22% of the US population,1 and nearly all of them receive medical care before reaching the age of 18. Pharmacists have a significant opportunity to engage with these patients and have a substantial impact on their use of medications.
When interacting with children, it is important to remember to include the caregiver and address all their concerns. The child’s age also affects how involved they can be in their treatment. Generally, children approximately 5 years of age and older can understand a simple explanation of how the prescribed medicine will help them.2 All their questions should be answered, and none should ever be dismissed as silly or unimportant.
In retail pharmacy, it is common for parents to come pick up prescriptions with their children, which means that pharmacists have an opportunity to introduce themselves as a friendly and approachable source of information. For parents of children younger than 8 years, making suggestions about how to disguise the flavor of a medicine to make it easier for the child to take can be very helpful. They should be told, for instance, that keeping a solution in the refrigerator can improve its taste and adding small amounts of grape juice or chocolate syrup to it can mask its flavor, but that they must make sure to add only a small amount of food or liquid to the drug as the child must take the full dose.3
Dosing errors are common in children and are another reason why pharmacists should provide advice on the safe administration of medications. To minimize mistakes, pharmacists can go over the child’s dosing when the prescription is picked up. They can show what the correct amount of a liquid medication is by using a syringe—and emphasize that parents use a safe and approved measuring tool—and, if possible, can also have the child take the first dose at the pharmacy.4
In the case of tablets, pharmacists can explain whether these can be crushed and mixed with applesauce or similar food. Likewise, they can help with the dosing of such OTC medication as ibuprofen and acetaminophen, explain what a safe administration frequency is, and specify when children should see a doctor. They should also give parents the number of the Poison Control Hotline (800-222-1222), tell them that it is free and confidential, and encourage them to call if they suspect poisoning or an overdose.
Whenever they dispense medications to adults who live with children, pharmacists should emphasize the importance of keeping medications in a safe, out-of-reach place.
They should take the time to educate toddlers and young children on poison prevention by explaining that they should never touch, taste, or smell unknown substances and always tell an adult about a suspected poison.5 Look-alike games can also be played: Show children pills and pieces of candy that look alike and ask them to identify which is which. Additional games, resources, and fun facts sheets are available at websites like pillsvscandy.com and poison.org, the National Capital Poison Center website. There are also engaging chil- dren’s books—among them Maddie Visits the Pharmacist and Pharmacy and Me—that explain the job a pharmacist does.
Pharmacists working in a pediatric hospital have even more opportunities to address potential dangers because the age of their patients will range from around 36 weeks to 18 years. These institutions are often decorated in bright, cheery colors and have lots of toys available. Being an upbeat and professional presence is important, as is giving clear information to kids and their caregivers and answering any questions they may have.
Pharmacists can also look for alternative ways to give medications and suggest better options to physicians when possible. For example, they can suggest that medications be given in oral, topical, or vapor form whenever possible to limit painful injections and always explain to the child what will happen when they receive a medication.
Those interested in a career in pediatric pharmacy can complete PGY1 and PGY2 pediatric hospital residencies and pursue a certification through the Board of Pharmacy Specialties. There are currently over 1450 board-certified pediatric pharmacy specialists in the US.6
Pediatrics is an ever-changing practice that focuses on the youngest patients. People who are passionate about making a difference in the lives of children and helping them when they are ill should learn more about the field. A good first step is to contact a local children’s hospital and ask to be put in touch with a pediatric pharmacist.
Finding a mentor in the field and pursuing a pediatric rotation may also be well worth-while as are organizing poison prevention classes for young kids and distributing fact sheets with tips for parents on how to best help children take medicine.
Pharmacy interns can also find ways to help children by watching out for them as they enter the drugstore with their parents and beginning a friendly conversation that explains such special services as flavoring options. It is important to point out that pharmacists can answer any medication question they may have.
The more we can empower pediatric patients to understand their disease and feel confident about their treatment, the more we can be certain that we have set them on the path to success and given them the tools and resources to safely manage medications. Along the way, we may even inspire a little future pharmacist.
Esther Banker is a 2024 PharmD candidate at Creighton University and a Jewel Osco pharmacy intern with a strong passion for all things pediatric.
1. The State of America’s Children 2021. Children’s Defense Fund. Accessed March 8, 2022. https://www.childrens- defense.org/state-of-americas-children/soac-2021-over-view/#:~:text=CHILD%20POPULATION%3A%20 America’s%20children%20are,percent%20of%20our%20 nation’s%20population
2. Christensen C. Overview of pediatrics. Lecture presented at: Creighton University School of Pharmacy and Health Professions. February 21, 2022; Omaha, NE.
3. Simpson N. What every pharmacist should know about pediatric pharmacy. Pharmacy Times. Accessed March 16, 2022. https://www.pharmacytimes.com/view/what-every-pharmacist-should-know-about-pediatric-pharmacy
4. Wu A. Minimizing medication errors in pediatric patients. US Pharmacist. Accessed March 17, 2022. https://www. uspharmacist.com/article/minimizing-medication-er- rors-in-pediatric-patients
5. Poison prevention services. Nationwide Children’s. Accessed March 14, 2022. https://www.nationwidechildrens.org/specialties/central-ohio-poison-center/poison-prevention-resources
6. Pediatric pharmacy. Board of Pharmacy Specialties. Accessed March 16, 2022. https://www.bpsweb.org/ bps-specialties/pediatric-pharmacy/#1517747602846- f1cc6832-24701517780015777151785407768915178 583338251517863453680