title: Design, evaluation, and dissemination of a plastic syringe clip to improve dosing accuracy of liquid medications.
abstract: Pediatricians in Africa requested a tool to improve caregiver dosing of liquid antiretroviral medication. We developed, evaluated and disseminated a clip to control the amount of medication drawn into an oral syringe. In a laboratory, a user tested clips of different lengths, corresponding to different volumes, by drawing water into a syringe with a clip. In Texas and Malawi, 149 adults attempted to measure Pepto-Bismol™ using a syringe with a clip, a syringe without a clip, and a dosing cup, in a randomly assigned order. In the laboratory, the volume of liquid, ranging from 1 to 4.5 mL, drawn into the syringe was always within at least 5 μL of the intended dose. In Texas, 84% of doses were accurate within ±10%, vs. 63% using the syringe alone, and 21% with the dosing cup. In Malawi, 98% of doses were accurate to within ±10%, vs. 90% using the syringe alone, and 27% with the dosing cup. For target accuracy values within ±45% (±21%), a significantly higher fraction of Houston (Kamangira) participants delivered an accurate dose using the syringe with the clip than with the syringe alone (p < 0.05). The clip enables a greater proportion of users to accurately measure liquid medication.
authors.affiliation: Rice 360°: Institute for Global Health Technologies, Rice University, 6100 Main St., Houston, TX 77005, USA.
authors.forename: Garrett J
authors.initials: GJ
authors.lastname: Spiegel
authors.forename: Cindy
authors.initials: C
authors.lastname: Dinh
authors.forename: Amanda
authors.initials: A
authors.lastname: Gutierrez
authors.forename: Julia
authors.initials: J
authors.lastname: Lukomnik
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lu
authors.forename: Kamal
authors.initials: K
authors.lastname: Shah
authors.forename: Tara
authors.initials: T
authors.lastname: Slough
authors.forename: Ping Teresa
authors.initials: PT
authors.lastname: Yeh
authors.forename: Yvette
authors.initials: Y
authors.lastname: Mirabal
authors.forename: Lauren Vestewig
authors.initials: LV
authors.lastname: Gray
authors.forename: Stephanie
authors.initials: S
authors.lastname: Marton
authors.forename: Michelle
authors.initials: M
authors.lastname: Adler
authors.forename: Gordon E
authors.initials: GE
authors.lastname: Schutze
authors.forename: Hadley
authors.initials: H
authors.lastname: Wickham
authors.forename: Maria
authors.initials: M
authors.lastname: Oden
authors.forename: Rebecca
authors.initials: R
authors.lastname: Richards-Kortum
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000930:Antidiarrheals / Q000008:administration & dosage*; D001729:Bismuth / Q000008:administration & dosage*; D004867:Equipment Design / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009942:Organometallic Compounds / Q000008:administration & dosage*; D012459:Salicylates / Q000008:administration & dosage*; D013594:Syringes / Q000592:standards* / Q000639:trends
chemical_list: D000930:Antidiarrheals; D009942:Organometallic Compounds; D012459:Salicylates; C015715:bismuth subsalicylate; D001729:Bismuth