Women's understanding of different dosing instructions for a liquid pediatric medication

Introduction: Dosing errors by caregivers are common and often are directly attributed to poorly designed instructions. The purpose of this study was to assess whether instruction wording--that is, implicit versus explicit dosage intervals--was associated with participants' ability to describe and correctly measure a dose of a commonly prescribed liquid pediatric prescription medication.

Methods: English-speaking women (N = 193) of child-bearing age were recruited to participate in this study from an outpatient residency clinic in the southeastern United States. Based on a priori randomization, each participant was presented with one of two medication bottles that were identical except for the instructions: (1) "shake liquid well and give (child's name) 6 ML by mouth every 12 hours" ("implicit" dosage interval)," or (2) "shake liquid well and give (child's name) 6 ML by mouth at 7 AM and 7 PM" ("explicit" dosage interval). Participants completed a structured interview to assess sociodemographic characteristics, health literacy skills, ability to describe and demonstrate the dosage of the liquid medication, and preferences for label format.

Results: Seventy-two participants (37.3%) were able to correctly describe how they would give the medicine to a child during a 24-hour period, while 145 women (75.1%) were able to correctly demonstrate how they would give one dose of the medication. Approximately one third of participants (32.1%) were able to correctly describe and measure a dose of the medication. Slightly more than half of participants (n = 103, 53.4%) indicated that they would prefer instructions with "explicit" dosage intervals.

Discussion: This study suggests that few people can accurately describe how liquid medications are to be administered, while more people can demonstrate the correct dose to be administered.