1. Paracetamol for feverish children: parental 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: 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?

4. 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.

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)

6. 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 < 0,05) Less educated parents sought advice from their own parents (62 % vs. 43 %, p < 0,05)

8. 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.

10. Discussion

11. 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