Original Contributions
Parental pediatric corticosteroid preferences*,**,*

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Abstract

Corticosteroids are often prescribed in the acute care management of asthma. Prednisolone can be administered intramuscularly (IM) or orally in 2 different concentrations. This study evaluated parental preference for three prednisolone preparations based on the route of administration, taste, and volume required. Accompanying adults (AAs) of pediatric patients were interviewed about their preferences based on the 3 factors. Those AAs who passed the health screen (51 of 214) were asked to taste 2 oral prednisolone preparations and reinterviewed about their corticosteroid preferences. Of the 214 AAs, 96% were parents. Of the group, 43% preferred IM corticosteroids whereas 40% preferred oral corticosteroids. Without considering taste as a factor for oral corticosteroids, 94% preferred the more concentrated syrup compared with the less concentrated one. When told that the less concentrated syrup tasted better, 58% preferred the less concentrated/better tasting syrup. After the 51 taste test subcohort subjects tasted the syrups, 96% preferred the less concentrated/ better tasting syrup over the more concentrated/poorer tasting syrup. Taste is more important than volume of administration for this particular corticosteroid comparison. Simply asking parents about their IM/oral and syrup formulation preferences may be the easiest way of optimizing their treatment plan. (Am J Emerg Med 2001;19:29-31. Copyright © 2001 by W.B. Saunders Company)

Section snippets

Methods

Oral corticosteroids tested: Two prednisolone sryups: Pediapred (1 mg/mL; Medeva, Surrey, UK) and Prelone (3 mg/mL; Muro Pharmaceuticals, Tewksbury, MA). No substitutions with generic prednisolone preparations were used.

Results

The characteristics of the 214 children with their AAs comprising the study cohort are summarized in Table 1.

. Demographics of the Study Cohort: 214 Children With Accompanying Adults

Mean age of children (years)3.5 ± 6 3
Mean weight of children (kg)15.5 ± 6 9
Relationship of AA to children
 Mother154 (72%)
 Father51 (24%)
 Other 9 (4%)
Medical insurance status of children
 Private172 (80%)
 Medicaid40 (19%)
 None2 (1%)
Characteristics of AAs
 Has a child with history of asthma or wheezing72 (34%)
 Has heard of

Discussion

Compliance with outpatient pediatric medications depends on factors, which include cost, side effects, route of administration, and dosing. This study attempts to provide information on the preferences of caregivers for steroid medications for their children. We compared route of administration and taste/volume of oral medication.

In this population, on initial questioning, preferences for IM versus oral were split roughly in half. Possible reasons for caregiver preference for an injection

References (7)

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Address reprint requests to Loren Yamamoto, MD, MPH, MBA, Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, 1319 Punahou Street, #718, Honolulu, HI 96826. E-mail: [email protected]

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Am J Emerg Med 2001;19:29-31.

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