A–Z of prescribing for children
This series focuses on aspects of prescribing for neonates, children and young people, from A–Z. Aspects of pharmacokinetics will be considered, alongside legal considerations, consent and medications in schools
It has been more widely accepted in recent years that the inclusion of patients in the therapeutic prescribing process is more beneficial to the patient, and concordance considers the wishes and expectations of both the prescriber and the patient (Atal et al, 2019), which also includes children. This is a shift in approach to patient care, but also terminology, where ‘compliance’ and ‘adherence’ have been used. The term compliance is now outdated, as it had a focus on patient obedience to instructions (Rae, 2021), which is not applicable to children not adhering to medication regimes. ‘Adherence’ is less autocratic than compliance, and there is a view that the prescriber is given more information to the patient before they agree to take the medication.
Even 20 years ago, consideration was given to children's roles in concordance (Sanz, 2003), as the prescribing process is not just a two-way, process but a three-way one: the prescriber, the child and the parents. It is imperative to consider all beliefs, thought processes, and expectations from all involved in order to negotiate a successful plan of care. Factors that potentially influence a child's ability to take their medication need to be explored. These can include family relationships and influences, actual medicine formulations, or beliefs about the medication effectiveness or side effects; all these factors can all play a part (Chappell, 2015).
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