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

Acad Pediatr. 2024 May-Jun;24(4):627-632. doi: 10.1016/j.acap.2023.08.020. Epub 2023 Sep 4.

Abstract

Objective: A 2015 survey of primary care providers (PCPs) found that while many believed that milliliter (mL)-only dosing was safest for oral liquid medications, few would use mL alone in dosing instructions. Since 2015, many recommendations have promoted "mL-only" dosing. In 2019, a follow-up survey was conducted to assess if PCP perceptions and practices have changed.

Methods: Pediatricians, family medicine physicians, nurse practitioners, and internists participating in the 2015 and 2019 DocStyles cross-sectional, web-based surveys were asked about their perceptions and practices regarding dosing units for oral liquid medications.

Results: In 2019, among 1392 respondents, the proportion of PCPs who reported they believed using mL-only is the safest dosing instruction ranged from 55.1% of internists to 80.8% of pediatricians. While fewer PCPs believed patients/caregivers prefer dosing instructions in mL-only (23.9% of nurse practitioners to 48.4% of pediatricians), more held this belief in 2019 compared to 2015; pediatricians had the greatest absolute increase (+14.4%) and family medicine physicians had the smallest increase (+1.3%). While 61.6% of pediatricians reported they would use mL-only dosing, only 36.0% of internists, 36.6% of nurse practitioners, and 42.5% of family medicine physicians reported they would do so. After controlling for age, gender, region, and specialty, 2019 PCP survey participants were more likely to report that they would use mL-only dosing compared to 2015 participants (adjusted odds ratio 1.51, 95% confidence interval 1.29-1.77).

Conclusions: Broader educational efforts may be necessary to reach nonpediatricians, to encourage prescribing and communication with patients/caregivers using mL-only dosing.

Keywords: dosing units; milliliters; oral liquid medications; primary care providers.

MeSH terms

  • Administration, Oral
  • Adult
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Internal Medicine
  • Male
  • Middle Aged
  • Nurse Practitioners
  • Pediatricians*
  • Physicians, Family
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Surveys and Questionnaires