A Berthe-Aucejo1, D Girard2, M Lorrot3, X Bellettre4, A Faye3, J C Mercier5, F Brion6, O Bourdon6, S Prot-Labarthe7. 1. Pharmacie, Hôpital Robert-Debré, APHP, Paris, France. 2. Unité d'Epidémiologie Clinique, AP-HP Hôpital Robert-Debré, Paris, France Pediatric Pulmonology Research Group, University Children's Hospital, Basel, Switzerland. 3. Service de pédiatrie Générale, AP-HP Hôpital Robert-Debré, Paris, France Université Paris 7 Denis Diderot, Sorbonne Paris Cité, Paris, France. 4. Service d'Accueil des Urgences Pédiatriques, AP-HP Hôpital Robert-Debré, Paris, France. 5. Université Paris 7 Denis Diderot, Sorbonne Paris Cité, Paris, France Service d'Accueil des Urgences Pédiatriques, AP-HP Hôpital Robert-Debré, Paris, France. 6. Pharmacie, Hôpital Robert-Debré, APHP, Paris, France Pharmacie clinique, Université Paris Descartes, Sorbonne Paris Cité, Paris, France Laboratoire Educations et Pratiques de Santé, EA 3412, Université Paris 13, Sorbonne Paris Cité, Paris, France. 7. Pharmacie, Hôpital Robert-Debré, APHP, Paris, France INSERM, U1123, ECEVE, Paris, France.
Abstract
OBJECTIVE: To study reconstitution and preparation dosing errors of liquid oral medications given by caregivers to children. METHODS: A prospective observational study was carried out in the departments of general paediatrics and emergency paediatrics at the Robert-Debré Children's University Hospital. An interview with caregivers involved (1) practical reconstitution and preparation of an oral liquid medication from a prescription drawn at random (amoxicillin (Clamoxyl, dosing spoon) or josamycin (Josacine, dose-weight pipette)) and (2) a questionnaire about their use. RESULTS: One hundred caregivers were included. Clamoxyl and Josacine were incorrectly reconstituted in 46% (23/50) and 56% (28/50) of cases, respectively, with a risk of underdosing of Clamoxyl (16/23) and overdosing of Josacine (23/28). Dose preparation with the dosing spoon was incorrect in 56% of cases, and in 10% of cases with the dose-weight pipette. Female sex, native French speaker, and age were significantly associated with correct reconstitution. Male sex and medication were significantly associated with correct preparation. CONCLUSIONS: This study highlights the high incidence of errors made by caregivers in reconstituting and preparing doses of these liquid oral medicines, which are associated with considerable risks of over- and underdosing. Factors associated with these errors have been identified which could help health professionals to optimise their strategy for educating families about the use of liquid oral medications and the need to check that they understand these instructions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
OBJECTIVE: To study reconstitution and preparation dosing errors of liquid oral medications given by caregivers to children. METHODS: A prospective observational study was carried out in the departments of general paediatrics and emergency paediatrics at the Robert-Debré Children's University Hospital. An interview with caregivers involved (1) practical reconstitution and preparation of an oral liquid medication from a prescription drawn at random (amoxicillin (Clamoxyl, dosing spoon) or josamycin (Josacine, dose-weight pipette)) and (2) a questionnaire about their use. RESULTS: One hundred caregivers were included. Clamoxyl and Josacine were incorrectly reconstituted in 46% (23/50) and 56% (28/50) of cases, respectively, with a risk of underdosing of Clamoxyl (16/23) and overdosing of Josacine (23/28). Dose preparation with the dosing spoon was incorrect in 56% of cases, and in 10% of cases with the dose-weight pipette. Female sex, native French speaker, and age were significantly associated with correct reconstitution. Male sex and medication were significantly associated with correct preparation. CONCLUSIONS: This study highlights the high incidence of errors made by caregivers in reconstituting and preparing doses of these liquid oral medicines, which are associated with considerable risks of over- and underdosing. Factors associated with these errors have been identified which could help health professionals to optimise their strategy for educating families about the use of liquid oral medications and the need to check that they understand these instructions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Entities:
Keywords:
General Paediatrics; Medical Education; Paediatric Practice; Therapeutics
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