(1209) Oral Liquid Medication Dosing Practices of Parents of Young Children—united States, 2022

Objectives: Liquid medications are involved in more than 80% of pediatric medication errors that occur outside of hospitals. Studies have demonstrated that parents and other caregivers, including those with low literacy, are not only familiar with metric units (i.e., milliliters [mL]), but can also safely and accurately dose medications using dosing devices with mL-alone, and make fewer errors compared to dosing using spoon-based (e.g., teaspoons) units. Therefore, the objective of this study was to assess oral liquid medication dosing practices among parents of young children (aged ≤5 years) in the United States.

Methods: Survey data were collected by Porter Novelli Public Services through an online panel representative of the U.S. population. The 2022 SummerStyles survey, conducted from May 31-July 6, 2022, was sent to 5,990 households. Demographic information of respondents was collected, and data were weighted to match U.S. Current Population Survey proportions using gender by age, household income, race/ethnicity, household size, education, census region, metro status, and parental status of children 11-17 years old. All analyses for this study were restricted to adult SummerStyles respondents who reported having at least one child aged ≤5 years. These participants were asked three, multiple choice, single-response questions about their oral liquid medication dosing practices: 1) “Think about the last twelve months. The last time you got a liquid medicine for your child that their doctor prescribed, what type of measuring tool, if any, did the pharmacy give you?”, 2) “Think about the last twelve months. The last time that you gave liquid medicine (over-the-counter or prescription medicine) to a child by mouth, what type of measuring tool did you use?”, and 3) “If you lost the measuring tool that came with a medicine, and had to give 5 mL to a child by mouth, what would you do?”

Results: A total of 4,156 adults completed the 2022 SummerStyles survey, a response rate of 69.3%. Of those that completed the survey, 1,307 reported that they had children under the age of 18 years, and 306 parents of children aged ≤5 years were included in the analysis. Nearly two-thirds of respondents reported that they had received a measuring tool from the dispensing pharmacy (65.2%, 95% confidence interval [CI] 59.0%-71.4%) the last time their child was prescribed liquid medicine; 2.3% (95% CI 0.2%-4.5%) did not receive a tool; and roughly one-third of parents reported that their child was not prescribed liquid medicine in the past 12 months. Oral syringes (43.8%, 95% CI 37.3%-50.4) and dosing cups (12.0%, 95% CI 8.0%-16.0%) were the most commonly reported dosing tools received from the pharmacy. When asked what type of measuring tool they had used when giving liquid medicine (over-the-counter [OTC] or prescription) to a child by mouth in the last twelve months, four-fifths of parents reported using either an oral syringe (48.3%, 95% CI 41.7%-54.8%) or dosing cup (31.1%, 95% CI 25.2%-37.1%); 12.1% (95% CI 7.6%-16.6%) did not give liquid medicine. When asked what they would do if they lost the measuring tool that came with a medicine and had to give 5 mL to a child by mouth, most parents (76.6%, 95% CI 71.0%-82.3%) reported that they would use the measuring tool with mL markings that came with another medication.

Conclusions: Overall, use of oral syringes and dosing cups to give oral liquid medications was high among parents of young children in the United States in 2022. Broader educational efforts may be necessary to encourage all pharmacies and manufacturers of OTC medicines to include a dosing device with mL units with all oral liquid medications.