I think we all could have guessed the result of this study, but sometimes even the "obvious" needs to be confirmed with good science.
Source: Yin HS, Parker RM, Sanders LM, et al. Liquid medication errors and dosing tools: A randomized controlled experiment. Pediatrics 2016 138: pii:e20160357. doi:10.1542/peds.2016-0357. See AAP Grand Rounds commentary by Dr. Mike Dubik (subscription required).
The focus of this study, trying to improve labelling and dosing of medications, is really a practical attempt to ensure children receive medication as prescribed. The investigators randomized over 2000 parents of children under 8 years of age to 1 of 5 different medication and dosing tools for liquid medication. They were tasked with measuring 3 different doses of medication, and then checked for accuracy. The "gold standard" group utilized mL units on the bottle label and the dosing tool (syringe or cup, with syringes showing either 0.5 mL of 0.2 mL increments), and accuracy of measurements were compared to other groups receiving a) both mL and "tsp" units on bottle and tool; b) mL and "teaspoon" on bottle and mL and "tsp" on tool; c) mL on bottle and mL and "tsp" on label; and d) "teaspoon" on bottle and mL and "tsp" on tool. I was a little confused with some of these mixed pairings, and it seems the parents also were confused. Most (84.4%) of parents made at least 1 dosing error, of which about 20% were felt to be a large error. Overall, syringes were better than cups, particularly for smaller dosages.
This actually was a very complex and well-designed study addressing a simple question. Although many factors are involved in having parents accurately deliver correct medication dosing, and the scenarios in this study were artificial, the results are likely convincing enough to translate into everyday practice. Get rid of the teaspoons and cups, and go with mL and syringes for liquid medication administration.
My apologies to the Sherman Brothers, a great songwriting team but perhaps not entirely on point with medication administration.
