Caregivers More Likely to Make Dosing Errors With Medication Cups
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In a study that compared caregivers’ dosing accuracy using a range of common dosing devices, medication cups were specifically associated with large overdosing errors, with caregivers who had low health literacy most likely to make errors.
The study included 302 caregivers (parents or legal guardians) who brought a child to the pediatric clinic at Bellevue Hospital Center (an urban public hospital in New York City) during an 8-week period in 2008. Participants were observed and assessed for dosing errors as they used a set of commonly available devices to measure a 5-mL dose (1 tsp) of acetaminophen suspension. The devices included two medication cups (one with printed calibration markings, one with clear etched markings), a dropper, a dosing spoon, and an oral syringe. In addition, the health literacy of all participants was estimated using a standardized test.
Only 30.5% of caregivers measured accurate doses (within 20% of the recommended dose) using the cup with printed markings and 50.2% measured accurate doses using the cup with etched markings, compared with more than 85% who measured accurate doses using the remaining instruments. Large dosing errors (>40% deviation) were made by 25.8% of caregivers using the cup with printed markings and 23.3% of caregivers using the cup with etched markings. More than 99% of the errors involving overdosing; caregivers with limited health literacy were most likely to make large dosing errors. Low health literacy also was found to be independently associated with dosing errors.
The study appears in the February 2010 issue of Archives of Pediatrics & Adolescent Medicine.
Arch Pediatr Adolesc Med. 2010;164:181-86.