Study Finds Oral Syringes Better for Liquid Pediatric Meds
A randomized controlled study has found that oral syringes are more accurate than dosing cups when parents measure doses of liquid medications for their children. The researchers concluded that oral syringes should be used to help reduce the incidence of medication errors, especially for smaller dosages. They also noted that drug labeling for liquid medications should avoid the use of either teaspoon or tsp as a measurement.
The study was conducted at three pediatric outpatient clinics in New York; Stanford, CA; and Atlanta and was published in the October issue of Pediatrics.1 It compared how accurately parents measured a liquid medication using either of two oral medication syringes (one marked in 0.2 mL increments and one marked in 0.5 mL increments) or a 30-mL dosing cup. The directions on the medication labels used five different types of units--such as mL, mL and teaspoon, mL and tsp, or teaspoon--while the markings on the measuring tool might or might not match the label.
The study randomly assigned 2,110 parents of children up to 8-years old into one of the five study arms. Each parent was presented with nine paired sets of medication labels and tools, and was asked to read the labels and measure out three amounts of a simulated liquid medication, for a total of nine doses measured. The labels called for 2.5, 5, and 7.5 mL amounts of medication. The sets of labels and tools were presented to the parents in random order.
The parents in the study included both English and Spanish speakers and were given their choice of labels and measuring tools marked in English or Spanish. Their health literacy was also assessed.
The main study goal was to determine whether altering the attributes of specific label and dosing tool could reduce liquid dosing errors. The chief criterion was whether the parent measured an amount of medication that was within 20% of the amount called for on the label.
The study found that 84.4% of parents made one or more dosing errors that were 20% greater or smaller than the amount called for. Overdosing was more common than underdosing: 68% of errors were overdoses. Errors were also more common when parents were asked to measure out 2.5 and 7.5 mL than 5 mL.
About 21% of parents made a large measuring error, defined as measuring out more than twice the correct amount of medication.