Parents’ knowledge, attitudes, and practice in childhood fever: an internet-based survey

Bont, Eefje de; Francis, Nick; Dinant, Geert-Jan; Cals, Jochen

doi:10.3399/bjgp14x676401

Cited by 62 publications

(73 citation statements)

References 18 publications

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“…However, referrals and multiple contacts within the system often resulted in dissatisfaction [37]. Parents indicated that antipyretics were used regularly to control fever symptoms [34,35,40,43,46]. Parents perceived that they knew how best to manage fever, yet non-evidence based practice was observed in the included studies.…”

Section: Summary Of Narrative Synthesismentioning

confidence: 96%

“…Parents' knowledge of fever varied widely [42]. Parents demonstrated a fear of fever, directly related to negative outcomes associated with fever such as febrile convulsions [34,43]. Parents who received safety netting advice were less likely to re-present to urgent and emergency care services [37].…”

Section: Summary Of Narrative Synthesismentioning

confidence: 96%

“…The majority of parents had visited the GP with a feverish child [33,34,43]. More than two in five parents (43.7 %) had visited an out-of-hours GP because of fever [34].…”

Section: Parental Practicesmentioning

confidence: 99%

“…Eleven studies were quantitative in nature [33][34][35][36][37][38][39][40][41][42][43], using questionnaires to gather information, the characteristics of which are represented in Table 3. Two of these studies reported results from the same study cohort [42,43].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Drivers for inappropriate fever management in children: a systematic review

et al. 2016

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Background Fever is one of the most common childhood symptoms and accounts for numerous consultations with healthcare practitioners. It causes much anxiety amongst parents as many struggle with managing a feverish child and find it difficult to assess fever severity. Over- and under-dosing of antipyretics has been reported. Aim of the review The aim of this review was to synthesise qualitative and quantitative evidence on the knowledge, attitudes and beliefs of parents regarding fever and febrile illness in children. Method A systematic search was conducted in ten bibliographic databases from database inception to June 2014. Citation lists of studies and consultation with experts were used as secondary sources to identify further relevant studies. Titles and abstracts were screened for inclusion according to pre-defined inclusion and exclusion criteria. Quantitative studies using a questionnaire were analysed using narrative synthesis. Qualitative studies with a semi-structured interview or focus group methodology were analysed thematically. Results Of the 1565 studies which were screened for inclusion in the review, the final review comprised of 14 studies (three qualitative and 11 quantitative). Three categories emerged from the narrative synthesis of quantitative studies: (i) parental practices; (ii) knowledge; (iii) expectations and information seeking. A further three analytical themes emerged from the qualitative studies: (i) control; (ii) impact on family; (iii) experiences. Conclusion Our review identifies the multifaceted nature of the factors which impact on how parents manage fever and febrile illness in children. A coherent approach to the management of fever and febrile illness needs to be implemented so a consistent message is communicated to parents. Healthcare professionals including pharmacists regularly advise parents on fever management. Information given to parents needs to be timely, consistent and accurate so that inappropriate fever management is reduced or eliminated. This review is a necessary foundation for further research in this area.

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Section: Summary Of Narrative Synthesismentioning

confidence: 96%

Section: Summary Of Narrative Synthesismentioning

confidence: 96%

“…The majority of parents had visited the GP with a feverish child [33,34,43]. More than two in five parents (43.7 %) had visited an out-of-hours GP because of fever [34].…”

Section: Parental Practicesmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Drivers for inappropriate fever management in children: a systematic review

et al. 2016

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“…1 As many parents work during the day and fever typically rises in the early evening, these rates are even higher during out-of-hours care. 1,2 In most cases, fever is caused by benign viral infections, and general recommendations given by a family physician are sufficient for management. 3 One in every 3 to 4 children who visit family physician out-of-hours care with a fever receives an antibiotic prescription, however.…”

Section: Introductionmentioning

confidence: 99%

Booklet for Childhood Fever in Out-of-Hours Primary Care: A Cluster-Randomized Controlled Trial

et al. 2018

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PURPOSE Fever is the most common reason for a child to be taken to a physician, yet the level of unwarranted antibiotic prescribing remains high. We aimed to determine the effect on antibiotic prescribing of providing an illness-focused interactive booklet on fever in children to out-of-hours primary care clinicians. METHODSWe conducted a cluster-randomized controlled trial in 20 out-ofhours general practice centers in the Netherlands. Children aged younger than 12 years with fever were included. Family physicians at the 10 intervention sites had access to an illness-focused interactive booklet between November 2015 and June 2016. The primary outcome was antibiotic prescribing during the index consultation. Analysis was performed by fitting 2-level random intercept logistic regression models. RESULTSThe trial took place among 3,518 family physicians and 25,355 children. The booklet was used in 28.5% of 11,945 consultations in the intervention group. Compared with usual care, access to the booklet did not significantly alter antibiotic prescribing during the index consultation (odds ratio = 0.90; 95% CI, 0.79-1.02; prescription rate, 23.5% vs 25.2%; intracluster correlation coefficient = 0.005). In contrast, use of the booklet significantly reduced antibiotic prescribing (odds ratio = 0.83; 95% CI, 0.74-0.94; prescription rate, 21.9% vs 25.2%; intracluster correlation coefficient = 0.002). Children managed by family physicians with access to the booklet were less likely to receive any drug prescription, and parents in the booklet group showed a reduced intention to consult again for similar illnesses.CONCLUSIONS Benefit of an illness-focused interactive booklet in improving outcomes of childhood fever in out-of-hours primary care was largely restricted to the cases in which family physicians actually used the booklet. Insight into reasons for use and nonuse may inform future interventions of this type. Ann Fam Med 2018;16:314-321. https://doi.org/10.1370/afm.2265. INTRODUCTIONF ever is the most common reason for a child to be taken to a physician, and most fever consultations take place in general practice.1 As many parents work during the day and fever typically rises in the early evening, these rates are even higher during out-of-hours care.1,2 In most cases, fever is caused by benign viral infections, and general recommendations given by a family physician are sufficient for management. One in every 3 to 4 children who visit family physician out-of-hours care with a fever receives an antibiotic prescription, however. 4,5 These prescription rates are nearly twice as high as those during routine office hours. 6 Consultations are generally driven by parental concerns about harmful consequences of fever. These concerns can be more prominent when needing to consult a family physician on call who is not their personal family physician. 7Previous studies have shown that antibiotic prescribing is strongly influenced by patients' expectations and that family physicians experience pressure from patients to presc...

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