Beyond knowledge gaps: service factors shaping caregiver use of medication information in paediatric oncology

Paediatric oncology care is increasingly delivered within diverse populations, where caregivers differ in language, cultural context, and familiarity with healthcare systems. Communication and information delivery often assume shared language and understanding, which may not reflect many families’ realities and can contribute to inequities in medication information access and use. In the context of complex, home-based medication regimens, these mismatches position medication management as a patient safety issue, yet variation in engagement with medication information in practice remains insufficiently understood. This study aimed to identify and describe the medication information needs and preferences of caregivers of children with cancer. A qualitative descriptive study was conducted at a tertiary paediatric oncology centre in New South Wales, located in one of Australia’s most linguistically and culturally diverse regions. Semi-structured interviews were conducted remotely with 15 caregivers of children receiving cancer treatment. Data were analysed using reflexive thematic analysis. Core medication information needs were consistent across the sample, including cognitive overload at treatment initiation, preference for staged and multimodal information, and reliance on written and demonstration-based support across caregivers from diverse linguistic and cultural backgrounds. However, variation emerged in how caregivers engaged with and operationalised medication information. Among caregivers born overseas, participants described difficulty processing complex verbal explanations, reliance on re-explanation or translation strategies, and valuing structured multidisciplinary clarification and reassurance. In contrast, caregivers born in Australia frequently reported uncertainty arising from inconsistencies across verbal, written, and electronic information sources. Across the sample, caregivers described functioning as key safety checkpoints within fragmented health systems, navigating inconsistencies across information sources in the absence of coordinated support. Medication information needs in paediatric oncology reflect the demands of managing complex medication systems rather than knowledge gaps alone. Strengthening medication safety requires system-level approaches that improve the consistency, design, timing, reinforcement, and accessibility of medication information within routine care, rather than simply increasing the amount of information provided.