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Milani GP, Corsello A, Schulz PJ, Fadda M, Giannì ML, Alberti I, Comotti A, Marchisio P, Chiappini E, Peroni D. Childhood fever and medical students: A multicentre, educational intervention. Acta Paediatr 2023; 112:1954-1961. [PMID: 37059701 DOI: 10.1111/apa.16790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 04/16/2023]
Abstract
AIM Misconceptions and non-evidence-based practices toward childhood fever are reported worldwide. Medical students might be ideal candidates to introduce long-lasting changes in clinical practice. However, no study has gauged the effectiveness of an educational intervention to improve fever management in this population. We conducted an educational, interventional study on childhood fever among final-year medical students. METHODS We conducted a prospective, multicentre interventional study employing a pre/post-test design. Participants from three Italian Universities filled in a questionnaire just before the intervention (T0), immediately after (T1) and 6 months later (T2) in 2022. The intervention was a two-hour lecture focused on the pathophysiology of fever, recommendations for its treatment and risks associated with improper management. RESULTS 188 final-year medical students (median age of 26 years, 67% females) were enrolled. Relevant improvements in the criterion for treating fever and conceptions about the beneficial effects of fever were observed at T1 and T2. Similar data were found for the reduction of physical methods advice to decrease body temperature and concerns for brain damage from fever. CONCLUSION This study shows for the first time that an educational intervention is effective in changing students' conceptions and attitudes toward fever both in the short and medium term.
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Affiliation(s)
- Gregorio P Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Antonio Corsello
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Peter J Schulz
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Department of Communication & Media, Ewha Womans University, Seoul, South Korea
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ilaria Alberti
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Comotti
- Occupational Health Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Marchisio
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Elena Chiappini
- Paediatric Infectious Disease Unit, Meyer Children's University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
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Silvagni D, Castagno E, Cardinale F, Chiappa S, Chiaretti A, Corsini I, Ferrari E, Masi S, Meli M, Peccarisi LG, Piccotti E, Tipo V, Vitale A, Zampogna S, Zangardi T. Management of fever in infants and children in the emergency setting and during home discharge: recommendations from an Italian panel. Minerva Pediatr (Torino) 2022; 74:195-201. [PMID: 35511631 DOI: 10.23736/s2724-5276.22.06666-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In infants and children, fever is very common in the emergency setting. The overall aim of the present publication was to overview guidance and provide an algorithm for use in the emergency setting as well as recommendations to inform parents for home care. To obtain consensus, a core steering committee drafted a management algorithm and general consensus was obtained by remote voting among experts. A number of common messages are found in current guidelines: management of fever depends on age, antipyretics are indicated only for discomfort; paracetamol or ibuprofen can be recommended; physical methods for lowering temperature are discouraged. A consensus algorithm is presented in which infants <28 days are considered separately, while those >28 days and <90 days are divided into those ill or well appearing. All infants <28 days with fever ≥37.5 °C should undergo complete work-up for sepsis, strongly considered to receive empirical antibiotics ± acyclovir, and be hospitalized. All infants (between 28 and 90 days) ill appearing should undergo diagnostic work-up for sepsis, receive empirical antibiotics, and be hospitalized. In well appearing infants, diagnostic work-up should be carried out to decide admission to hospital and administration of antibiotics. Specific recommendations are also given for home discharge that can be used to inform parents about the actions to take during home care in the attempt to reinforce existing guidelines. At present, physical examination and laboratory tests, along with best clinical judgement and postdischarge guidance following a defined algorithm, are the foundation of management of febrile children.
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Affiliation(s)
- Davide Silvagni
- Department of Pediatric Emergency, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy -
| | - Emanuele Castagno
- Unit of Pediatric Emergency, Regina Margherita Children's Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Fabio Cardinale
- Unit of Pediatrics and Pediatric Emergency, Consorziale-Policlinico University Hospital, Giovanni XXIII Childern's Hospital, University of Bari, Bari, Italy
| | | | - Antonio Chiaretti
- Unit of Pediatric Emergency, Department of Woman, Child and Public Health Science, Child Health Area, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Ilaria Corsini
- Unit of Pediatric Emergency, S. Orsola-Malpighi IRCCS Polyclinic Hospital, IRCCS, Bologna, Italy
| | | | | | - Mariaclaudia Meli
- Gaspare Rodolico Polyclinic University Hospital, San Marco, Catania, Italy
| | | | | | - Vincenzo Tipo
- Santobono Pausilipon University Hospital, Naples, Italy
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Zhang C, Zhang L, Qiong L, Zeng L, Wu D, Qin F. Systematic review of methodology and reporting quality of global guidelines on fever in children. Medicine (Baltimore) 2021; 100:e28021. [PMID: 35049213 PMCID: PMC9191381 DOI: 10.1097/md.0000000000028021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/11/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the global clinical practice guidelines on fever in children. We also aimed to select a guideline with good methodology and reporting quality to provide scientific reference for diagnosis and treatment of fever in children. METHODS The Chinese and English databases Embase, PubMed, Cochrane library, China National Knowledge Infrastructure, Wanfang database, clinical guides, and the website of the Department of Public Health Administration were retrieved up to January 2020. The clinical practice guidelines on fever in children were included. The AGREE II instrument and Reporting Items for Practice Guidelines in Healthcare statement were used to evaluate the methodology and reporting quality of the guidelines. RESULTS Eight clinical guidelines for fever in children were included. Methodological quality assessment showed that the recommendation level of ISP, South Africa, National Institute for Health and Care Excellence, China, and American College of Emergency Physicians were grade B (recommended with modification), while that of American Academy of Pediatrics, New South Wales, and South Australia was grade C recommendation (not recommended). No grade A recommendation guideline was found. The reporting quality from higher to lower was National Institute for Health and Care Excellence, the Chinese guideline, American College of Emergency Physicians, ISP, South Africa, New South Wales, South Australia, and American Academy of Pediatrics. The guideline recommendations were similar in various countries, but they were slightly different in various aspects, including body temperature measurement and the timing of drug administration. CONCLUSION There are limitations in the methodology and reporting quality of all eight global guidelines on fever in children. For future development of these guidelines, attention should be paid to improving applicability of the guidelines in terms of methodology. Additionally, the principles and explanations for formation of recommendations should be described, as well as the limitations of the reporting guideline in detail in terms of the reporting quality. Treatments of fever in children are similar in different countries, but there are still differences that require further research.
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Affiliation(s)
- Chuan Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Lingli Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Liao Qiong
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Linan Zeng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Di Wu
- West China school of pharmacy, Sichuan University, Chengdu, China
| | - Fang Qin
- West China school of pharmacy, Sichuan University, Chengdu, China
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Vicens-Blanes F, Miró-Bonet R, Molina-Mula J. Analysis of Nurses' and Physicians' Attitudes, Knowledge, and Perceptions toward Fever in Children: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312444. [PMID: 34886174 PMCID: PMC8656872 DOI: 10.3390/ijerph182312444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 02/05/2023]
Abstract
CONTEXT Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents that health professionals share. OBJECTIVE To investigate whether doctors' and nurses' knowledge, perceptions, and attitudes toward fever influence how this sign is managed. Furthermore, it intends to evaluate whether educational programs increase knowledge and change attitudes and/or perceptions of nurses about children's fever. DATA SOURCES A systematic review with meta-analysis was conducted with PRISMA international standards and the Cochrane recommendations. STUDY SELECTION Articles examining health professionals' (doctors and/or nurses) knowledge, perceptions, and/or attitudes toward fever in children and the use of antipyretics were selected for the study. DATA EXTRACTION The qualitative analysis was carried out by classifying the articles according to the applied educational programs for nurses related to fever care for children that evaluated different outcomes to determine their efficacies. RESULTS For the qualitative synthesis, 41 articles were included, and 5 of these were taken in meta-analysis, which measured the effectiveness of educational programs for fever management in nurses. LIMITATIONS All of the included studies generally had a high risk of bias. CONCLUSION According to the evidence reviewed, nurses' and physicians' perceptions and attitudes regarding fever management in children indicate an overtreatment of this sign. We can give a recommendation grade of D on the use of educational programs to modify attitudes, perceptions, and knowledge about fever in children and improve clinical practice in nurses.
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Kasbekar R, Naz A, Marcos L, Liu Y, Hendrickson K, Gorsich JC, Baun M. Threshold for defining fever varies with age, especially in children: A multi-site diagnostic accuracy study. Nurs Open 2021; 8:2705-2721. [PMID: 33735515 PMCID: PMC8363342 DOI: 10.1002/nop2.831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/30/2020] [Accepted: 01/31/2021] [Indexed: 11/23/2022] Open
Abstract
Aim The American Academy of Pediatrics and the European Centre for Pediatric and Adolescent Medicine guideline define fever as a temperature >38.0°C for all ages and recommend use of rectal thermometers in children <3 years. Based on new literature, this definition of fever using a fixed threshold of 38.0°C needs to be re‐examined. Design A multi‐site diagnostic accuracy study was conducted to compare an “age‐based” threshold model with a “fixed” threshold over 38.0°C on a total of 894 patients of which 373 were ill. Methods The “age‐based” and “fixed” threshold fever determinations were then compared to a clinical categorization (“well” or “ill”) conducted by a clinician through a comprehensive examination. Results The sensitivity and accuracy for the age‐based thresholds were found to be superior to the fixed thresholds in all ages and current ear thermometers were found equivalent to rectal thermometers in infants <6 months.
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Affiliation(s)
- Rajesh Kasbekar
- Kaz USA, Inc., a Helen of Troy Company, Marlborough, MA, USA
| | - Aftab Naz
- Madera Family Medical Group, Madera, CA, USA
| | | | - Yingjie Liu
- Merck Sharp & Dohme Corp, North Wales, PA, USA
| | | | - James C Gorsich
- Kaz USA, Inc., a Helen of Troy Company, Marlborough, MA, USA
| | - Matt Baun
- Kaz USA, Inc., a Helen of Troy Company, Marlborough, MA, USA
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Gaffney GR, Bereznicki LR, Bereznicki BJ. Knowledge, beliefs and management of childhood fever among nurses and other health professionals: A cross-sectional survey. NURSE EDUCATION TODAY 2021; 97:104731. [PMID: 33385941 DOI: 10.1016/j.nedt.2020.104731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/30/2020] [Accepted: 12/13/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Fever phobia, the unfounded fear regarding the potential harms of fever in children, has been internationally documented among parents. This fear causes anxiety in parents and health professionals are regularly consulted for advice. OBJECTIVES This study aimed to investigate the knowledge, beliefs and recommended treatments among Australian nurses, pharmacists, general practitioners and paediatricians in the management of febrile children. DESIGN, SETTING AND PARTICIPANTS This was an online cross-sectional survey of Australian nurses, pharmacists, general practitioners and paediatricians designed to evaluate the knowledge and preferred recommendations in the management of febrile children. METHODS The health professionals were recruited via Facebook. Demographic information, knowledge, beliefs and preferred treatments were collected through the online survey, and responses were compared across professions. RESULTS Of the 839 health professionals who completed the survey, 52.0% correctly identified a fever as 38 °C or above. Overall, 23.6% underestimated the temperature that constitutes a fever. Respondents reported concerns leaving fever untreated in children, with dehydration (65.1%), seizures (65.2%), serious illness (34.4%) and brain damage (29.9%) the most common concerns. Pharmacists were more likely to hold these concerns. The beliefs that reducing a child's fever with medication will reduce the risk of harm (34.7%) and prevent febrile convulsions (51.1%) were prevalent among respondents. These beliefs were more common among pharmacists. Pharmacists were also more likely to recommend parents monitor a child's temperature (48.5%) and give medication to reduce fever (64.6%). CONCLUSIONS Australian nurses, pharmacists, general practitioners and paediatricians reported many misconceptions surrounding the definition of fever, the potential harms of fever and its management, which may perpetuate parental fears. These misconceptions were most common among pharmacists. Continuing professional development is essential to ease unfounded concerns and ensure the safe and judicious care of febrile children.
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Affiliation(s)
- Georgina R Gaffney
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | - Luke R Bereznicki
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
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Balaguer Martínez JV, del Castillo Aguas G, Gallego Iborra A. Antibiotics prescription and complementary tests based on frequency of use and loyalty in Primary Care. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.anpede.2017.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Balaguer Martínez JV, del Castillo Aguas G, Gallego Iborra A. Prescripción de antibióticos y realización de pruebas complementarias en función de la frecuentación y de la fidelización en Atención Primaria. An Pediatr (Barc) 2018; 89:197-204. [DOI: 10.1016/j.anpedi.2017.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/17/2017] [Accepted: 11/21/2017] [Indexed: 11/29/2022] Open
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Lucas S, Leach M, Kumar S. Complementary and alternative medicine utilisation for the management of acute respiratory tract infection in children: A systematic review. Complement Ther Med 2018; 37:158-166. [PMID: 29609928 DOI: 10.1016/j.ctim.2018.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION As many as one in two children across the globe use complementary and alternative medicine (CAM) to manage a health condition. Despite the high prevalence of use, there is still limited information on the types of CAM used in children, particularly for the management of one of the most common childhood health complaints - acute respiratory tract infection (ARTI). This systematic review was undertaken to address this knowledge gap. METHODS Eligible studies reporting the use of CAM in children with ARTI were identified using a targeted search of seven electronic databases and the grey literature. Data were extracted using a customised data extraction form and appraised using the McMaster critical review forms for quantitative and qualitative studies. Findings were synthesised in narrative form. RESULTS The search identified 2261 papers, of which 22 studies were eligible for inclusion. The 22 studies reported the use of 118 distinct CAM interventions for the management of ARTI in children. Most (53%, n = 63) of these interventions represented biologically-based therapies, followed by whole medical systems/alternative medical systems (46%, n = 55). No studies reported the use of energy therapies, or manipulative and body-based methods, or mind-body therapies. CONCLUSION A diverse range of CAM interventions are used in the management of ARTI in children. These interventions largely represent CAM use in the southern region of Asia - India, Pakistan and Bangladesh. Further research is needed to better understand the types of CAM used among children with ARTI in western countries.
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Affiliation(s)
- S Lucas
- School of Health Sciences, University of South Australia, Adelaide, South Australia, North Tce. Adelaide SA 5000, Australia.
| | - M Leach
- Department of Rural Health, University of South Australia Adelaide, South Australia, North Tce. Adelaide SA 5000, Australia.
| | - S Kumar
- School of Health Sciences, University of South Australia, Adelaide, South Australia, North Tce. Adelaide SA 5000, Australia.
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Fever and Pain Management in Childhood: Healthcare Providers' and Parents' Adherence to Current Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050499. [PMID: 27187436 PMCID: PMC4881124 DOI: 10.3390/ijerph13050499] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/17/2016] [Accepted: 05/09/2016] [Indexed: 01/16/2023]
Abstract
In order to evaluate the adherence of healthcare providers and parents to the current recommendations concerning fever and pain management, randomized samples of 500 healthcare providers caring for children and 500 families were asked to complete an anonymous questionnaire. The 378 health care providers (HCPs) responding to the survey (75.6%) included 144 primary care pediatricians (38.1%), 98 hospital pediatricians (25.9%), 62 pediatric residents (16.4%), and 71 pediatric nurses (19.6%); the 464 responding parents (92.8%) included 175 whose youngest (or only) child was ≤5 years old (37.7%), 175 whose youngest (or only) child was aged 6–10 years (37.7%), and 114 whose youngest (or only) child was aged 11–14 years (24.6%). There were gaps in the knowledge of both healthcare providers and parents. Global adherence to the guidelines was lower among the pediatric nurses than the other healthcare providers (odds ratio 0.875; 95% confidence interval 0.795–0.964). Among the parents, those of children aged 6–10 and 11–14 years old, those who were older, and those without a degree answered the questions correctly significantly less frequently than the others. These findings suggest that there is an urgent need to improve the dissemination of the current recommendations concerning fever and pain management among healthcare providers and parents in order to avoid mistaken and sometimes risky attitudes, common therapeutic errors, and the unnecessary overloading of emergency department resources. Pediatric nurses and parents with older children, those who are older, and those with a lower educational level should be the priority targets of educational programmes.
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Bertille N, Pons G, Khoshnood B, Fournier-Charrière E, Chalumeau M. Symptomatic Management of Fever in Children: A National Survey of Healthcare Professionals' Practices in France. PLoS One 2015; 10:e0143230. [PMID: 26599740 PMCID: PMC4658127 DOI: 10.1371/journal.pone.0143230] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 11/02/2015] [Indexed: 12/02/2022] Open
Abstract
Despite the production and dissemination of recommendations related to managing fever in children, this symptom saturates the practices of primary healthcare professionals (HPs). Data on parent practices related to fever are available, but data on HPs’ practices are limited. We studied HPs’ practices, determinants of practices and concordance with recommendations in France. We conducted a national cross-sectional observational study between 2007 and 2008 among French general practitioners, primary care pediatricians and pharmacists. HPs were asked to include 5 consecutive patients aged 1 month to 12 years with acute fever. HPs completed a questionnaire about their practices for the current fever episode. We used a multilevel logistic regression model to assess the joint effects of patient- and HP-level variables associated with this behavior. In all, 1,534 HPs (participation rate 13%) included 6,596 children (mean age 3.7 ± 2.7 years). Physicians measured the temperature of 40% of children. Primary HPs recommended drug treatment for 84% of children (including monotherapy for 92%) and physical treatment for 62% (including all recommended physical treatments for 7%). HPs gave written advice or a pamphlet for 13% of children. Significant practice variations were associated with characteristics of the child (age, fever level and diagnosis) and HP (profession and experience). In France, despite the production and dissemination of national recommendations for managing fever in children, primary HPs’ observed practices differed greatly from current recommendations, which suggests potential targets for continuing medical education.
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Affiliation(s)
- Nathalie Bertille
- Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, Paris, France
- Department of General Pediatrics, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
- * E-mail:
| | - Gerard Pons
- Clinical Pharmacology, Groupe hospitalier Cochin-Broca-Hôtel Dieu, AP-HP Paris-Descartes University, Paris, France
- Inserm U663 Pediatric epilepsies and brain plasticity, Paris, France
| | - Babak Khoshnood
- Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
| | | | - Martin Chalumeau
- Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France
- Department of General Pediatrics, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
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Sellier-Joliot C, Di Patrizio P, Minary L, Boivin JM. [AFSSAPS 2005 recommendations have not modified the way parents take care of children's fever]. Arch Pediatr 2015; 22:352-9. [PMID: 25727470 DOI: 10.1016/j.arcped.2014.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 09/29/2014] [Accepted: 12/27/2014] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Fever in children is frequent. Often mild, initial care is the parents' responsibility: medicinal treatments and medical consultations. Unfortunately, the efficiency of parental care is poor. Therefore, in 2005 the AFSSAPS updated its recommendations. One and 6 years after publication of the guidelines, this study rates their impact by describing and comparing parents' knowledge and behavior when faced with fever in their children. MATERIAL AND METHODS This survey was conducted in families whose children were attending preschool in and near Metz (France) in 2006 and 2012. The same questionnaire was given to assess the knowledge, care, and symptoms of serious fever. The results were processed based on the number of children in the family and the family's socioeconomic category. RESULTS In 2006, 1038 questionnaires were distributed and 1273 in 2012. The fever threshold was not better known in 2012. Bathing and uncovering children remained the predominant physical methods used. Treatment was based on the use of ibuprofen and alternating treatments. However, the conditions of administering medication were well known to parents. The causes and motives for consultation were not better understood in 2012 however. The main source of information was physicians. DISCUSSION The message disseminated since 2005 has not been efficient. Its complexity has not eradicated old beliefs and inappropriate parental practices. A campaign based on a brief, simple message has to be organized, providing better chances of being assimilated by the public. Medical practices should be standardized.
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Affiliation(s)
- C Sellier-Joliot
- Département de médecine générale, faculté de médecine de Nancy, université de Lorraine, 9, avenue de la forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France
| | - P Di Patrizio
- Département de médecine générale, faculté de médecine de Nancy, université de Lorraine, 9, avenue de la forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France
| | - L Minary
- Pôle S2R, épidémiologie et évaluation clinique, CHU de Nancy, 54000 Nancy, France
| | - J-M Boivin
- Département de médecine générale, faculté de médecine de Nancy, université de Lorraine, 9, avenue de la forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France; CIC-P-Inserm, CHU de Nancy, 54000 Nancy, France.
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