Changes in Provider Perceptions and Practices Regarding Dosing Units for Oral Liquid Medications

Area of Science:

• Medical Education
• Patient Safety
• Pharmacology

Background:

• Many primary care providers (PCPs) perceive milliliter (mL)-only dosing as the safest method for oral liquid medications.
• Despite this perception, actual use of mL-only dosing instructions has lagged, indicating a gap between belief and practice.

Purpose of the Study:

• To assess changes in PCP perceptions and practices regarding mL-only dosing for oral liquid medications between 2015 and 2019.
• To identify differences in perceptions and practices among various PCP specialties.

Main Methods:

• Cross-sectional web-based surveys (DocStyles) were administered to pediatricians, family medicine physicians, nurse practitioners, and internists in 2015 and 2019.
• Participants were queried on their beliefs and reported practices concerning mL-only dosing units for oral liquid medications.

Main Results:

• In 2019, a majority of PCPs believed mL-only dosing was safest (55.1%-80.8% by specialty), with increased belief in patient/caregiver preference for mL-only compared to 2015.
• While pediatricians reported the highest likelihood of using mL-only dosing (61.6%), adoption was lower among internists (36.0%) and nurse practitioners (36.6%).
• Overall, PCPs in 2019 were significantly more likely to report using mL-only dosing than in 2015 (adjusted odds ratio 1.51).

Conclusions:

• While PCP belief in the safety of mL-only dosing has grown, consistent adoption of mL-only instructions requires further intervention.
• Targeted educational initiatives are crucial to promote mL-only prescribing and communication, particularly for non-pediatric specialists.