Paracetamol for feverish children: parental motives and experiences

1
Paracetamol for feverish childrenparental
motives and experiences

• University of Copenhagen
• Department of General Practice

2
Background

• Statistics in Denmark
• Sale of paracetamol for children increased 25
  in five years.
• Paracetamol poisoning cases tripled between
  1997 - 2007.
• Internationally Wide use of paracetamol against
  fever.
• HOWEVER, evidence of paracetamol against fever is
  still unclear.
• Overdosing may cause poisoning Liver damage and
  death.

3
Objective

• Explore Danish parents use of paracetamol (PA)
  for feverish children
• To what extend, and when do parents give PA
  against fever?
• What motivates parents to give PA?
• - Expectations of beneficial effect?
• - Fear of fever Fever Phobia?
• 3. Where do parents seek information on handling
  a feverish child?

4
Method

• Cross-sectional structured interview survey.
• Population Danish parents with at least one
  child lt age of 10.
• Setting Four general practices in city, suburb
  and rural area.
• Interview guide Developed from international
  studies and pilot tested on 15 parents.
• 47 items, approximately 15 minutes to complete.

5
Results

• 100 participants
• 3 in 4 parents had ever administered PA to a
  feverish child.
• PA was most often given WHEN? To reduce
  temperature
• When a child is in pain
• When a child needs to sleep
• By WHO? Highly educated (OR 4,4) and
  self-medicators (OR 4,7)

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Results

• Motives
• Fever phobia exists 77 - fever may harm a
  child
• 58 - fever may cause boiling of child
• 34 - fever may cause brain damage
• but NO clear ass0ciation with paracetamol use.
• Expectations of PA effects 89 - child feels
  better
• 86 - child sleeps easier
• 45 - child has more appetite
• 41 - fever seizures avoided
• associated with higher use of paracetamol

7
Results

• Information
• Most parents (92 ) asked their
• General Practitioner!
• Highly educated found info on the internet and in
  books/magazines
• (75 vs. 47 , p lt 0,05)
• Less educated parents sought advice from their
  own parents
• (62 vs. 43 , p lt 0,05)

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Discussion

• Primary findings
• 1 Vague indications Parents often give PA to
  feverish children often not supported by
  evidence.
• 2 Highly educated parents administer PA more
  often.
• 3 Fever Phobia may NOT be the cause of wide PA
  use parental expectations influence use.
• 4 GP is primary source of information.

9
Discussion

• Influences of parental PA use?
• Easy access (over-the counter) and advertising.
• Confidence in effects of PA role of fever?
• No time for illness in Danish families?
• GP information gap between common knowledge
  and medical evidence.

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Discussion

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Discussion

• GPs what can we do?
• Inform parents about management of fever and PA
  use
• - Indications for use
• - Dosing for children
• - Risks of and signs of poisoning.
• THANK YOU ?