ปัจจัยที่มีผลต่อความคลาดเคลื่อนในการตวงยาน้ำสำหรับเด็กของผู้ปกครอง

Abstract

The objective of this research was to study the effect of drug viscosity, volume of medicine to be measured, dosing devices, units of volume on the drug label and health literacy (HL) on dosing errors of pediatric liquid medicines among parent. The subjects were 333 parents of children under 12 years old who completed the THLA-W+ (Thai Health Literacy Assessment Using Word List with Extended Questions to Test Comprehension) to assess their HL and were categorized into those with adequate and inadequate levels of HL. The subjects were asked to measure the medicine under the condition randomly chosen for them by the researcher. There were 8 conditions in the study: 2 levels of viscosity (low - high) x 2 units of volume (teaspoon or milliliter) x 2 devices (teaspoon or syringe). Each subject measured 5 volumes, i.e. half, 0.6, three-quarter, 1 and 1.5 teaspoons for those getting teaspoon as the volume unit, and 2.5, 3, 3.75, 5 and 7.5 milliliters for those getting milliliters as the volume unit. The data were analyzed using generalized estimating equation. It was found that device x unit x HL Interaction and device x unit x volume Interaction showed a statistically significant effect on dosing error. Viscosity had no effect on dosing error. The incongruence between unit of volume on drug label and measuring tool increased dosing error. Dosing error when unit = teaspoon and tool = teaspoon was less than that when unit = teaspoon and tool = syringe (absolute errors were 13.0527.99% and 26.12-42.96%, respectively). In the case of unit of volume = teaspoon and device = teaspoon, 68.29% and 76.83% of subjects were able to accurately measure half and 1 teaspoon of the drug, respectively. However only 47.56-57.31% of the subjects were able to accurately measure the drug at the volume of 0.6, three-quarter and 1.5 teaspoons. When the unit of volume = milliliter and device = syringe, there were 85.88-96.47% of subjects correctly measuring the drug. When unit of volume = ml and tool = syringe, it became an easy task to measure the medicine with 90% of people with insufficient HL being able to measure medication correctly. If unit of volume = teaspoon and toolt = teaspoon, 55.61% and 67.32% of those with insufficient and sufficient HL, respectively were able to accurately measure the drug, respectively. Public health organizations should promote to the use of milliliters as unit volume on drug labels and distribute syringe when dispensing liquid medicine. Use the teaspoon as volume unit on drug label and teaspoon as a device should be done only when the volume of the medication to be measured is half or 1 teaspoon. Dispensing of liquid medicine should avoid the incongruence between volume unit and distributed dosing device.