Identifying and Advancing Best Practices for the Labeling and Dosing of Pediatric Liquid Medications: Progress and Challenges

Yin, H. Shonna; Vuong, Carrie L.; Parker, Ruth M.; Sanders, Lee; Mendelsohn, Alan L.; Dreyer, Benard P.; Velazquez, Jessica J.; Wolf, Michael S.

doi:10.1016/j.acap.2018.07.012

Cited by 2 publications

(2 citation statements)

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“…Poor maternal education results in poor health literacy. Health literacy and socioeconomic status of families were found to be strongly associated with dosing errors in studies [ 26 , 30 , 31 ]. The mothers in our study with a poor education status committed more errors than those with a better education status.…”

Section: Discussionmentioning

confidence: 99%

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Can use of pictograms reduce liquid medication administration errors by mothers? An interventional study

2021

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Background Liquid medication dosing errors (LMDE) made by caregivers affect treatment in children, but this is not a well-studied topic in many low-and middle-income countries including in India. Methods An intervention study was conducted among mothers attending a pediatric outpatient clinic of a tertiary care setting in Ujjain, India. The mothers randomly measured 12 volumes of a paracetamol liquid preparation by using a dropper (0.5 and 1 mL), measuring cup (2.5 and 5 mL), and calibrated spoon (2.5 and 5 mL) each with two instructions—oral-only measurement session (OMS) and oral plus pictogram measurement session (OPMS, the intervention). The main outcome was dosing error prevalence. The effectiveness of the intervention was assessed by measuring effect size. Risk factors for maximum LMDE were explored using backward multivariate logistic regression models. A P value of < 0.05 was considered statistically significant. Results In total, 310 mothers [mean (± SD) age, 30.2 (± 4.18) years] were included. LMDE prevalence in the OMS versus OPMS for dropper 0.5 mL was 60% versus 48%; for l mL dropper was 63% versus 54%; for 2.5 mL cup 62% versus 54%; for 2.5 calibrated spoon 66% versus 59%; 5 mL cup 69% versus 57%; and 5 mL calibrated spoon 68% versus 55%. Comparing OMS with OPMS, underdosing was minimum with the calibrated spoon for 2.5 mL (OR 4.39) and maximum with the dropper for 1 mL (OR 9.40), and overdosing was minimum with the dropper for 0.5 mL (OR 7.12) and maximum with the calibrated spoon for 2.5 mL (OR 13.24). The effect size (dCohen) of the intervention OPMS was 1.86–6.4. Risk factors for the most prevalent dosing error, that is, with the calibrated spoon for 2.5 mL, were increasing age of the mother (aOR 1.08; P = 0.026) and nuclear family (aOR 2.83; P = 0.002). The risk of dosing errors decreased with higher education of the mothers. Conclusions Pictograms can effectively minimize LMDE even in less educated mothers.

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Section: Discussionmentioning

confidence: 99%

“…A better communication between patients and providers can minimize dosing errors among mothers with a poor socioeconomic status and education status [ 17 , 32 , 33 ]. Improved health communication can prevent dosing error-induced adverse drug reactions by 72% [ 31 ].…”

Section: Discussionmentioning

confidence: 99%