Child Prescriptions a Dilemma for Picky Parents

Prescriptions for antibiotics are usually filled; vitamins are often skipped.

Sept. 24, 2012— -- In the minds of parents, not all prescriptions are created equal when it comes to the medicines and nutritional supplements doctors order for their kids.

A new study published today in the journal Pediatrics suggests that parents are usually good about filling their kids' prescriptions for antibiotics, but not their vitamins.

"Our current understanding has mostly revolved around why people don't take medications once they have them at home," said lead study author Dr. Rachel Zweigoron, associate professor of pediatrics at the Medical University of South Carolina. "This study shows that over 20 percent of prescriptions were never even filled."

The study is the first to look at prescription filling in pediatric primary care, and this population is unique compared to adults who might choose not to fill their own prescriptions.

"The motivation for wanting [any] prescription just isn't the same as wanting an antibiotic, perhaps because the results aren't as dramatic," said Dr. Maria Alkureishi, a general pediatrician at the University of Chicago Comer Children's Hospital, who was not involved in the study.

For a child with an ear infection, for example, "parents for the most part will move heaven and earth to get them seen by a doctor," Alkureishi said. "Their motivation to fill that antibiotic prescription is huge, because they believe it will bring comfort and relief to the child and it will normalize their family life."

On the other hand, for a child who has low iron in his or her blood, a parent might overlook the need for medication because such kids often look perfectly fine in most cases.

"The parents need to believe the doctor's judgment that their child needs more iron and will need to take a medication that doesn't taste good at all, one to two times a day, for at least a month before their blood work shows any effect, not so dramatic," Alkureishi added.

In the study, Children's Hospital of Chicago researchers looked at 4,800 children who were prescribed nearly 17,000 prescriptions. They found that one out of every five prescriptions for children seen in the clinic was not picked up from the pharmacy, and that whether a prescription was filled also depended on what the medication was for.

Researchers found that oral antibiotics were most likely to be filled; these drugs found their way to young patients 91 percent of the time. Nutritional supplements like vitamins, however, were only filled 65 percent of the time. Also near the bottom of parents' priority lists were medicines for certain gastrointestinal conditions such as reflux and constipation. These were only filled 71 percent of the time.

The discrepancies might be result, in part, from a parent's immediate motivation. But while antibiotics might be helping kids feel better in the short-term, vitamins are essential in long-term growth and development, especially in cities such as Chicago where healthy food might not be available in certain areas.

In 2008, a joint project between Chicago State University and the University of Illinois-Chicago found that 22 out of 77 Chicago communities -- almost 30 percent -- did not have a large grocery store or supermarket.

Still, other factors might make it more likely that prescriptions are filled for kids, such as being black or Hispanic, being younger than 1, and having doctors prescribe electronically, where they send the prescription directly to the pharmacy through the computer.

These prescriptions still have to be picked up, though.

"There is no sense in prescribing something if it's going to sit in the pharmacy unfilled," Alkureishi of Chicago Comer Children's Hospital said. "Kids are dependent on their loved ones for their care, and if the prescription isn't being filled, that care is not optimal."