Adherence among Italian paediatricians to the Italian guidelines for the management of fever in children: a cross sectional survey

Abstract

BackgroundItalian guidelines for the management of fever in children (IFG) have been published in 2009 and thereafter disseminated in all country. A survey was conducted before their publication and three years later to investigate their impact on knowledge and behaviors of paediatricians.MethodsA questionnaire was administered to convenient samples of paediatricians in 2009 and in 2012, eliciting information about fever definition, methods of temperature measurement, and antipyretic use. Differences in responses between 2009 and 2012 and between paediatricians who were or were not aware of the IFG were evaluated.ResultsThe responses rates were 74% (480/648) in 2009 and 69% (300/434) in 2012. In 2012 168/300 (56%) of participants were aware of the IFG. The proportion of paediatricians who correctly would never suggest the use of physical methods increased from 18.7% to 36.4% (P < 0.001). In 2009 11% of paediatricians declared that the use of antipyretic drugs depends on patient discomfort and did not use a temperature cut off. In 2012 this percentage reached 45.3% (P < 0.001). Alternate use of antipyretics decreased from 27.0% to 11.3% (P < 0.001). Use of rectal administration of antipyretics in absence of vomiting decreased from 43.8% in 2009 to 25.3% in 2012 (P < 0.001). In general, improvements were more striking in paediatricians who were aware of the IFG than in those who were not aware of them.ConclusionsBehaviours of Italian paediatricians improved over time. However, some wrong attitudes need to be further discouraged, including use of physical methods and misuse of rectal administration. Further strategy to disseminate the IFG could be needed.

Assessment of the knowledge of medical officers in the management of children presenting with febrile illnesses

“…The overall response rate was 90% which was satisfactory. This is in contrast to the response rates recorded by Chiappini et al 11 of 74% in 2009 and 69% in 2012. Level of knowledge was assessed using 80 pretested self-administered questions which are most appropriate when the level of education was high.…”

“…The study by Demir and Sekreter 10 also found that 91.3% of physicians stated that they advised parents to alternate the use of ibuprofen and paracetamol. About 90.5% in our study knew that if the response is poor to paracetamol ibuprofen has to be started Another cross-sectional study was conducted in Italy to assess the knowledge of paediatricians based on Italian guidelines for the management of fever (IFG) in children 11 . Differences in responses between 2009 and 2012 and between paediatricians who were or were not aware of the IFG were evaluated.…”

Educational interventions on fever management in children: A scoping review

“…Most of this fear is from lack of knowledge and education (Blumenthal, 1998) leading to non-evidence-based management (Zyoud et al, 2013). While international guidelines have been implemented (Baker et al, 2009;Chiappini et al, 2013;National Collaborating Centre for Women's and Children 's Health (UK), 2013;NSWHealth, 2010;SAHealth, 2013), many physicians still debate fever harms and treatments (El-Radhi, 2012). A recent study by Raffaeli et al (2016), evaluating views and practices of healthcare providers, found that over 30% could not correctly define a fever and many did not know recommended doses of antipyretics (Raffaeli et al, 2016).…”

“…Interventions directed at caregivers were found to target different concerns such as reducing fever anxiety (O'Neill-Murphy, Liebman, & Barnsteiner, 2001), increasing the amount of information given to parents (Considine & Brennan, 2007), or focusing on measuring and improving knowledge (Emmerton et al, 2014). Despite educational intervention, caregivers continue to adopt inappropriate and non-evidence-based practices (Chiappini et al, 2013;Monsma, Richerson, & Sloand, 2015;O'Neill-Murphy et al, 2001;So & Moles, 2014;Zyoud et al, 2013).…”

A study of treatment patterns in symptomatic management of fever in children (antipyresis) among Pediatricians

“…Some authors consider tympanic measurement the best method for non-invasive measurement [10], some authors recommend an axillary measurement because it is easy to perform and generally well tolerated. However, it is not very sensitive [11,12].…”