Inadequacies in the pharmacologic management of ambulatory children

Mattar, Mary E.; Markello, James R.; Yaffe, Sumner J.

doi:10.1016/s0022-3476(75)80090-4

Cited by 49 publications

(21 citation statements)

References 5 publications

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“…6,8,9 Studies have examined errors associated with parental health literacy and numeracy and their ability to correctly measure doses of medications. [10][11][12][13][14] Numerous studies have investigated the dosing inaccuracies of various medication administration devices, such as an oral syringe, dosing spoon, dropper, and dosing cup, 11,[15][16][17][18][19] whereas others have examined the variability of labeling and packaging of medications. 12,20,21 Most studies have been based on relatively small convenience samples, and only a few have used statewide or national databases.…”

Section: Methodsmentioning

confidence: 99%

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

et al. 2014

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OBJECTIVE: To investigate out-of-hospital medication errors among young children in the United States. METHODS: Using data from the National Poison Database System, a retrospective analysis of out-of-hospital medication errors among children <6 years old from 2002 through 2012 was conducted. RESULTS: During 2002–2012, 696 937 children <6 years experienced out-of-hospital medication errors, averaging 63 358 episodes per year, or 1 child every 8 minutes. The average annual rate of medication errors was 26.42 per 10 000 population. Cough and cold medication errors decreased significantly, whereas the number (42.9% increase) and rate (37.2% increase) of all other medication errors rose significantly during the 11-year study period. The number and rate of medication error events decreased with increasing child age, with children <1 year accounting for 25.2% of episodes. Analgesics (25.2%) were most commonly involved in medication errors, followed by cough and cold preparations (24.6%). Ingestion accounted for 96.2% of events, and 27.0% of medication errors were attributed to inadvertently taking or being given medication twice. Most (93.5%) cases were managed outside of a health care facility; 4.4% were treated and released from a health care facility; 0.4% were admitted to a non–critical care unit; 0.3% were admitted to a critical care unit; and 25 children died. CONCLUSIONS: This is the first comprehensive study to evaluate the epidemiologic characteristics of out-of-hospital medication errors among children <6 years of age on a national level. Increased efforts are needed to prevent medication errors, especially those involving non–cough and cold preparations, among young children.

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Section: Methodsmentioning

confidence: 99%

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

et al. 2014

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“…Several studies have documented the inaccuracy of this method, especially when families use household teaspoons instead of a measuring teaspoon (the volume of teaspoons ranges from 2 to 9 mL). [3][4][5][6] Research has suggested that parents may be confused about differences among teaspoons, tablespoons, and dose cups. 2,7,8 Problems can also result from spillage and medication left in or on the measurement device rather than administered to the child.…”

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confidence: 99%

Parents Can Dose Liquid Medication Accurately

1997

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“…7 Variability in measured volume capacity of household teaspoons has been reported in many studies, ranging from as little as 1.5 mL to as much as 9 mL. [1][2][3][4][5] Because pediatric doses for medications are generally weight-based, small variations in measured amounts may result in considerable under-or overdoses. Case reports and data from poison control centers have documented significant morbidity in pediatric patients from inadvertent overdoses using household spoons, as well as worsening illness from underdoses of critical medications.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported that the use of household spoons for administering medications to children is widespread. [1][2][3] However, teaspoons and tablespoons are inaccurate measuring devices, and volume capacities vary considerably. [1][2][3][4][5] In 2011, the US Food and Drug Administration issued several guidelines to manufacturers of over-the-counter liquid medications, including the recommendation that calibrated dosage delivery devices (DDDs) be dispensed with all such medications.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] However, teaspoons and tablespoons are inaccurate measuring devices, and volume capacities vary considerably. [1][2][3][4][5] In 2011, the US Food and Drug Administration issued several guidelines to manufacturers of over-the-counter liquid medications, including the recommendation that calibrated dosage delivery devices (DDDs) be dispensed with all such medications. 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.…”

Section: Introductionmentioning

confidence: 99%

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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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Inadequacies in the pharmacologic management of ambulatory children

Cited by 49 publications

References 5 publications

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

Out-of-Hospital Medication Errors Among Young Children in the United States, 2002–2012

Parents Can Dose Liquid Medication Accurately

Factors Associated With Dispensing Dosage Delivery Devices

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