Confusing Children's Medication Information

NLM Director's Comments Transcript: Confusing Children's Medication Information
01/18/2011
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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National of Medicine.

Here is what's new this week in MedlinePlus.listen

A review of 148 popular, over-the-counter medications recently published in the Journal of the American Medical Association finds widespread inconsistencies in recommended dose directions plus other barriers that make it confusing for consumers to use liquid medications for children as intended.

The study's five authors (led by a pediatrician at New York University School of Medicine) assessed the over-the-counter, liquid medications marketed for children under age 12 that were the most purchased between 2008-2009. The assessed medications included: cough/cold medicines, allergy and stomach disorder relief.

Overall, the study found 146 of the 148 top-selling, over-the-counter children's liquid medications contained inconsistencies between the product's recommended dose directions and the markings on included measuring devices.

More specifically, the markings on measuring devices (such as a small cup) did not match the terms used in dose instructions in 24 percent of the products. The included measuring devices contained superfluous information in 81 percent of the 146 questioned products.

About 11 percent of the 146 products contained atypical or non-standard units, such as drams, that either did not clarify or match the information provided in the product's recommended dose directions.

There were 163 abbreviations on children's medication products that were undefined. Non-standard abbreviations for standardized terms, such as a 'milliliter,' were used in 97 products.

While the authors are careful not to criticize children's over-the-counter medication manufacturers within the JAMA study, in a presentation to the Institute of Medicine (IOM) earlier this year, they noted the findings suggest why consumers have difficulty following medication directions.

At their IOM presentation, three of the study's five authors (who are members of an IOM health literacy working group) noted the study's findings also provide insights about why Americans sometimes fail to adhere to medication instructions.

Within the JAMA study, the authors note the U.S. Food and Drug Administration (FDA) recently changed its recommendations to manufacturers of approved over-the-counter liquid medications that address the lack of clarity, variability, and confusion suggested within the findings.

Among other changes, the FDA's new recommendations ask manufacturers to match measures on inserted devices with labeled dose instructions, avoid superfluous measures on the devices, explain abbreviations, and use only well-accepted drug dose and measurement terms.

The authors conclude top selling pediatric liquid medications contained (and we quote) 'highly variable and inconsistent dosing directions and measuring devices' (end of quote) at the time the FDA's new recommendations were issued. In other words, the study suggests the FDA's new recommendations were merited, if not overdue.

To help you understand over-the-counter medication instructions, MedlinePlus.gov's medication errors health topic page contains links to websites that help clarify some common sources of confusion.

For example, the Institute of Safe Medication Practices provides a list of error prone abbreviations, symbols, and dose designations within the 'related issues' section.

Similarly, MedlinePlus.gov's over-the-counter medicines health topic page contains information from the FDA about how to interpret over-the-counter medication labels. This link also is found in the 'related issues' section.

Both MedlinePlus.gov's over-the-counter medicines and medication errors health topic pages additionally contain an array of health and safety information, links to ongoing, related clinical trials in your area, the latest research summaries, and links to recent, related medical research.

To find MedlinePlus.gov's medication errors health topic page, type 'medication errors' in the search box on MedlinePlus.gov's home page, then, click on 'medication errors (National Library of Medicine).' To find MedlinePlus.gov's over-the-counter medicines health topic page, type 'over-the-counter medicines' in the search box on MedlinePlus.gov's home page, then, click on 'over-the-counter medicines (National Library of Medicine).'

MedlinePlus.gov also has a health topic page devoted to health literacy.

Overall, the JAMA study is a sobering call to address the clarity of instructions within popular children's over-the-counter medications, which the FDA's new recommendations hopefully will resolve.

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Confusing Children's Medication Information