Paracetamol for feverish children:

parental motives and experiences

University of CopenhagenDepartment of General Practice

BackgroundStatistics 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.

ObjectiveExplore Danish parents’ use of paracetamol (PA) for feverish

children:

1. To what extend, and when do parents give PA against fever?

2. 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?

Method

Cross-sectional structured interview survey.

Population: Danish parents with at least one child < 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.

Results100 participants

3 in 4 parents had ever administered PA to a feverish child.

PA was most often given WHEN? To reduce temperatureWhen a child is in painWhen a child needs to

sleep

By WHO? Highly educated (OR: 4,4) and “self-medicators” (OR 4,7)

ResultsMotives: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 better86 % - child sleeps easier45 % - child has more appetite41 % - fever seizures avoided

……associated with higher use of paracetamol

Results

Information:

Most parents (92 %) asked their General Practitioner!

Highly educated found info on the internet and in books/magazines

(75 % vs. 47 %, p < 0,05)

Less educated parents sought advice from their own parents

(62 % vs. 43 %, p < 0,05)

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.

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.

Discussion

Discussion

• GP’s – 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