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

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.

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.

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.

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.