Evaluation of Measuring Devices Packaged With Prescription Oral Liquid Medications

Ag, Johnson; Meyers, Rachel

doi:10.5863/1551-6776-21.1.75

Cited by 5 publications

(5 citation statements)

References 10 publications

(13 reference statements)

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“…In an attempt to determine the availability and accuracy of dosing devices, Bayor et al [ 6 ] found that dosing devices were not packaged with 46% and 97% of orthodox and herbal oral liquid medicines, respectively, on the Ghanaian market. A similar trend was found in the research by Johnson and Meyers [ 7 ] where it was revealed that only 12.8% of 382 liquid prescription medications were packaged with a dosing device. Consequently, caregivers are compelled to use devices such as household spoons to deliver required medication doses.…”

Section: Introductionsupporting

confidence: 84%

“…A study assessing compliance of OTC liquid products with these guidelines showed a glaring need for improvements in dosing devices for these products, with 98.6% of products having a discrepancy between the dose on the label and the measuring device in the package [ 10 ]. There are reports of adherence to the recommendations [ 14 ]; however, dosing device availability remains woefully inadequate as it is still not a standard practice for dosing tools to be provided in the clinical or community pharmacy setting [ 7 , 15 ]. Further, the provision of dosing devices for prescription medications is inadequate compared to OTC medications.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the Availability and Accuracy of Dosing Devices Packaged with Oral Liquid Medications in the Ho Municipality of Ghana

et al. 2022

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Introduction. Administering the right dose of medications is essential in avoiding potentially life-threatening adverse drug reactions. Industry guidelines for manufacturers of oral, over-the-counter, and liquid medications recommend including dose-delivery devices with packaging to limit dosing inaccuracy. This study describes the prevalence and accuracy of dosing devices packaged with oral liquid medications in the Ho municipality of Ghana. Methods. Dosing device accuracy was determined after deviation of the measured volume from the expected volume was evaluated using the United States Pharmacopoeia criteria. Results. A total of 78.6% of the oral liquid medications were packaged with a dosing device. The most common dosing devices were cups (83.6%), followed by spoons (14.3%), droppers (1.4%), and syringes (0.7%). The volumes measured with cups (5.14 ± 0.52 mL, p = 0.006 ) and spoons (5.3 ± 0.67 mL, p < 0.001 ) were significantly different from the desired 5 mL volume; this was dissimilar to the volume measured using syringes (5.01 ± 0.02 mL, p > 0.999 ). Further, the measured volumes for 38.6% and 72.2% of the cups and spoons, respectively, deviated by more than 15% of 5 mL. Conclusion. Dosing cups and spoons are associated with significant inaccuracy. Yet, manufacturers continually favour them over syringes in packaging for oral liquid medications. This is unacceptable and of considerable concern due to the risk of variations in therapeutic outcomes. Therefore, strict regulatory directives on the inclusion of accurate dosing devices in the packaging of oral liquid medicines are needed to reduce the possibility of medication errors.

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Section: Introductionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Assessment of the Availability and Accuracy of Dosing Devices Packaged with Oral Liquid Medications in the Ho Municipality of Ghana

et al. 2022

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“…For the last 15 years or so, there is a call to make this requirement mandatory for all liquid medicines (OTC and prescription) [50,51]. Studies have reported that provision of a suitably calibrated measuring device is now commonly seen with OTC liquid medicines but not for all prescription medicines, even in developed countries [52,53].…”

Section: Administering the Right Dosementioning

confidence: 99%

Medicines for children: Rationale and recent advances

Ranganathan

2017

J. Postgrad. Inst. Med.

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“…Although measuring cups or calibrated droppers are now included with most over-the-counter pediatric liquid medications, there are currently no regulations requiring that DDDs, such as oral syringes or dosing spoons, be dispensed with liquid prescription medications and given instructions for their use. A recent study by Johnson and Meyers 6 reported variable dispensing practices for delivery devices in a chain community pharmacy for liquid prescription medications. To our knowledge, no other published studies have focused on local, regional, or national pharmacy practice patterns, which remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Dispensing Dosage Delivery Devices

Wojewoda¹,

Chou²

2017

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVES A potential cause of medication errors in children is imprecise measurements, particularly using household spoons. There are no regulations requiring dispensing dose delivery devices (DDDs) with liquid prescription medications. Local, regional, and national pharmacy practice patterns are largely unknown. This study sought to determine how frequently devices are provided with prescription pediatric liquid medications with instructions for their use at pharmacies in Bronx, New York, and to examine which pharmacy and pharmacist characteristics are associated with reported practices.METHODS All pharmacies in Bronx, New York, were identified using an online telephone directory. A telephone survey was administered to the senior-level pharmacist that elicited availability of DDDs, whether pharmacy policy regarding dispensing devices existed, the pharmacist's personal practice of dispensing devices, and years in practice. RESULTSIn total, 268 pharmacies were contacted; 214 had free DDDs (79.9%) most of the time, 97.8% had them available to buy, and 160 (59.7%) had no policy regarding dispensing devices. Overall, 199 pharmacists (74.3%) routinely dispensed devices, and 195 (73.3%) demonstrated the use of devices. However, 94 pharmacists (35.3%) recommended using a household spoon to measure correct doses at least some of the time. Pharmacists were less likely to give devices as their years in practice increased.CONCLUSIONS In our study, many Bronx pharmacies had no policy regarding dispensing DDDs for prescription liquid medications, and dispensing practices varied among pharmacists based on years in practice. If similar trends are found in other areas, standardizing pharmacy policy and pharmacists' practices may decrease morbidity in children due to medication measurement errors.ABBREVIATIONS DDD, dosage delivery devices

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Evaluation of Measuring Devices Packaged With Prescription Oral Liquid Medications

Cited by 5 publications

References 10 publications

Assessment of the Availability and Accuracy of Dosing Devices Packaged with Oral Liquid Medications in the Ho Municipality of Ghana

Assessment of the Availability and Accuracy of Dosing Devices Packaged with Oral Liquid Medications in the Ho Municipality of Ghana

Medicines for children: Rationale and recent advances

Factors Associated With Dispensing Dosage Delivery Devices

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