“We need to recognize that parents have preferences, and we need to help them understand when to treat and when not to treat. We need to give them more than just a list of side effects. They need to know which ones are more common, which are more dangerous, and what to do in the face of each side effect,” said Voepel-Lewis.

“Overcoming preferences is not rocket science. Parents have experienced nausea and vomiting, so it seems like a serious complication. Sedation, on the other hand, seems quiet and restful. It is an absence of symptoms. But sedation is the side effect that could be deadly. We need more simple interventions – maybe a simple checklist. Can you wake up your child easily? If not, don’t give the medication,” said Zikmund-Fisher.

Where Do We Go From Here?

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“I would like to do a study on how the preferences of children affect pain management. Younger children may not ask for pain medication if it makes them feel nauseous. Older children may be able to take an active role in their pain management. Addiction may be an important factor influencing preferences in older children,” said Voepel-Lewis. “Parents get mixed messages from their doctors, the media, and pharmaceutical advertising. No wonder they struggle with making decisions about pain management. We need to do a better job of giving them a healthy balance of information.”

“A logical next clinical study would be the use of simple interventions. We should take what we have learned from this study and cut to the chase,” said Zikmund-Fisher. “Since we have learned that preferences can blunt knowledge, we need to give different weight to different side effects. Instead of lots of information, we need to give more weight to the most important information.”


1. Voepel-Lewis T, et al. Int J Nurs Stud. 2015; doi: 10.1016/j.ijnurstu.2015.05.003.