Objectives: Limited literature has investigated caregiver sharing of prescription medications with children. Our primary aim was to determine the frequency of and factors associated with prescription medication sharing within families. Our secondary aim was to determine the source and type of medications shared. Methods:We conducted a survey of a convenience sample of caregivers of children 1 to 17 years in a pediatric emergency department. The survey was developed through literature review, iterative feedback, and pilot testing on caregivers. We used logistic regression to identify factors associated with any history of medication sharing with a child in the home (primary outcome). Results:We enrolled 550 primary caregivers; 68 of the 535 analyzed (12.7%; 95% confidence interval [CI], 10.0-15.8) reported prescription medication sharing with their child/children. Of those who shared, 50 (73.5%) shared asthma medications and 14 (20.6%) shared antibiotics. Of the caregivers who shared prescription medications, 70.6% shared a medication for one child with another child, whereas 33.8% of caregivers shared their own or another adult's medication with their child. A child in the home with asthma (adjusted odds ratio [aOR], 3.35; CI, 1.82-6.17), a greater number of children in the household (aOR, 1.29; CI, 1.04-1.60), and a caregiver who previously shared medications with other family members and/or friends (aOR, 4.10; CI, were factors independently associated with medication sharing.Conclusions: Prescription medication sharing within families is common and most often involves asthma medications. We identified several factors associated with prescription medication sharing that could be used to target caregivers for preventative interventions.

Objectives:The aims of the study were to determine the frequency of and factors associated with leftover or expired prescription medication ("leftover medication") presence in homes with children and to assess caregivers' reported behaviors and knowledge regarding disposal of leftover medications in the home.Methods: This study is a planned secondary analysis from a survey of primary caregivers of children aged 1 to 17 years presenting to an emergency department. The survey assessed leftover medications in the home and medication disposal practices, knowledge, and guidance. The survey was developed iteratively and pilot tested. Multivariable logistic regression was used to identify factors associated with leftover medication presence in the home. Results:We enrolled 550 primary caregivers; 97 of the 538 analyzed (18.0%; 95% confidence interval [CI], 14.8-21.5) reported having leftover medications in their home, most commonly antibiotics and opioids. Of respondents, 217/536 (40.5%) reported not knowing how to properly dispose of medications and only 88/535 (16.4%) reported receiving guidance regarding medication disposal. Most caregivers reported throwing leftover medications in the trash (55.7%) or flushing them down the toilet (38.5%). Caregivers with private insurance for their child were more likely to have leftover medications (adjusted odds ratio [aOR], 1.99; CI, 1.15-3.44), whereas Hispanic caregivers (aOR, 0.24; CI, 0.14-0.42) and those who received guidance on leftover medications (aOR, 0.30; CI, 0.11-0.81) were less likely to have leftover medications in the home.Conclusions: Leftover medications are commonly stored in homes with children and most caregivers do not receive guidance on medication disposal. Improved education and targeted interventions are needed to ensure proper medication disposal practices.