Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 6:16:1612169.
doi: 10.3389/fphar.2025.1612169. eCollection 2025.

Insights on pediatric medication initiation: perceptions of caregivers and children

Maria Rubio-Valera  1   2   3   4 , Cristina Carbonell-Duacastella  1   3 , Maite Peñarrubia-María  3   5   6 , Eva Pacheco  6   7 , Patricia Gabriela-Ricciardeli  2 , Ignacio Aznar-Lou  1   3 , Montserrat Gil-Girbau  1   8
Affiliations

Insights on pediatric medication initiation: perceptions of caregivers and children

Maria Rubio-Valera et al. Front Pharmacol. .

Abstract

Introduction: Children fail to initiate a high proportion of medications but little is known about motivations for non-initiation.

Objective: To explore the factors affecting the decision to initiate a medication prescribed to children from caregivers' and children's perspectives.

Methods: Qualitative study based on Grounded theory using a constructivist approach. Twenty-one caregivers and six children (<18 years old) were individually interviewed between 2021 and 2022 in Spain using a semi-structured thematic guide. Interviews were transcribed and analyzed by pharmacists, pediatricians and family physicians through a constant comparative analysis and results were internally audited.

Results: Caregivers and healthcare professionals are the central figures involved in the decision-making process regarding treatment initiation; children were rarely involved. Caregivers, usually mothers, made a risk-benefit evaluation based on the perception of the disease and the medication, which was influenced by intrapersonal factors (emotional burden, health literacy and stigma); children-related factors (age, treatment and emotional burden); and factors related to the professionals (accessibility, discourse alignment, information, respect and emotional support, trust and specialty); healthcare system (trust and use of e-consultations) and context (media, peer pressure and social stigma).

Conclusion: The decision to initiate medication in the pediatric population is multifactorial and influenced by perceptions on the disease and treatment, intrapersonal factors related to the caregivers and children, and interpersonal factors and factors related to the healthcare system and contexts. An informed, shared decision-making process that considers both the participation of children and the needs for support from caregivers when prescribing a treatment could promote initiation in the pediatric population.

Keywords: medication; medication adherence; patient participation; pediatrics; qualitative research.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Summary of the research iterative methods.
FIGURE 2
FIGURE 2
Theoretical model for pediatric medication initiation.
See this image and copyright information in PMC

References

    1. Adams R. C., Levy S. E. COUNCIL ON CHILDREN WITH DISABILITIES (2017). Shared decision-making and children with disabilities: pathways to consensus. Pediatrics 139, e20170956. 10.1542/peds.2017-0956 - DOI - PubMed
    1. Ahmed C. V., Jolly P., Padilla L., Malinga M., Harris C., Mthethwa N., et al. (2017). A qualitative analysis of the barriers to antiretroviral therapy initiation among children 2 to 18 months of age in Swaziland. Swaziland 16, 321–328. 10.2989/16085906.2017.1380677 - DOI - PMC - PubMed
    1. Aznar-Lou I., Fernández A., Gil-Girbau M., Sabés-Figuera R., Fajó-Pascual M., Peñarrubia-María M. T., et al. (2017). Impact of initial medication non-adherence on use of healthcare services and sick leave: a longitudinal study in a large primary care cohort in Spain. Br. J. Gen. Pract. 67, e614–e622. 10.3399/bjgp17X692129 - DOI - PMC - PubMed
    1. Aznar-Lou I., Pottegård A., Fernández A., Peñarrubia-María M. T., Serrano-Blanco A., Sabés-Figuera R., et al. (2018). Effect of copayment policies on initial medication non-adherence according to income: a population-based study. BMJ Qual. Saf. 27, 878–891. 10.1136/BMJQS-2017-007416 - DOI - PubMed
    1. Baiocco R., Gattinara P. C., Cioccetti G., Ioverno S. (2017). Parents’ reactions to the diagnosis of duchenne muscular dystrophy: associations between resolution, family functioning, and child behavior problems. J. Nurs. Res. 25, 455–463. 10.1097/JNR.0000000000000186 - DOI - PubMed

LinkOut - more resources