About 57% of pediatricians and 31% of other primary care providers (PCPs) would use
only milliliters (mL) when prescribing liquid medications, even though the practice
is recommended to improve patient safety, according to a survey of 1,501 PCPs.
Studies have shown that parents may use household spoons when instructions are given
in teaspoons, which can result in dosing errors. Confusion between mL and teaspoons
also can harm patients.
A 2015 AAP policy statement calls on pediatricians to use mL-based dosing exclusively
when prescribing and administering oral liquid medications, http://pediatrics.aappublications.org/content/135/4/784. Numerous health care organizations also endorse the practice, and clinicians taking
part in the federal government’s Quality Payment Program will receive incentives if
their health technology automatically uses mL when liquid medications are prescribed.
To find out how PCPs dose liquid medications and their perceptions of using only mL,
researchers analyzed data from a 2015 survey of pediatricians, family practitioners,
nurse practitioners and internists. Participants were asked which unit of measurement
is safest, which unit they think caregivers prefer and which unit they would use in
dosing instructions for oral liquid amoxicillin.
Results showed that 59% of PCPs said using mL alone is safer than using teaspoons,
tablespoons or a combination of units. Pediatricians were more likely than other PCPs
to say mL-only dosing is safest (81% vs. 55%).
In addition, 72% believed caregivers prefer dosing instructions that use spoon-based
units alone or with mL. Those who held this belief were less likely to prescribe liquid
medications in only mL.
The authors called for more clinician education on how mL-only prescribing can reduce
errors. They also noted that the survey was conducted two months after the AAP policy
“Future studies should assess whether there has been broader implementation of recommendations
as awareness of the AAP Policy Statement and other efforts increase,” they wrote.