Dataset Information

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

ABSTRACT: BACKGROUND: Italian 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. METHODS: A 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. RESULTS: The 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. CONCLUSIONS: Behaviours 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.

SUBMITTER: Chiappini E

PROVIDER: S-EPMC3878332 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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

Chiappini Elena E D'Elios Sofia S Mazzantini Rachele R Becherucci Paolo P Pierattelli Monica M Galli Luisa L de Martino Maurizio M

BMC pediatrics 20131218

<h4>Background</h4>Italian 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.<h4>Methods</h4>A questionnaire was administered to convenient samples of paediatricians in 2009 and in 2012, eliciting information about fever definition, methods of temperature measurement, and antip ...[more]

PMID: 24350822

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Project description:BackgroundPoint-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability.Methods and findingsA cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks. Questions focused on the availability and use of currently available POCTs. Data were analysed descriptively and using Median Odds Ratio (MOR) to measure variation between countries. Multilevel regression modelling using changes in the area under the receiver operating characteristic curve of models were used to assess the contribution of individual or workplace versus country level factors, to the observed variation. The commonest POCT was urine dipsticks (UD) which were available to >80% of primary care and hospital paediatricians in 68% (13/19) and 79% (23/29) countries, respectively. Availability of all POCTs varied between countries. In primary care, the country (MOR) varied from 1.61 (95%CI: 1.04-2.58) for lactate to 7.28 (95%CI: 3.04-24.35) for UD. In hospitals, the country MOR varied from 1.37 (95%CI:1.04-1.80) for lactate to 11.93 (95%CI:3.35-72.23) for UD. Most paediatricians in primary care (69%, 795/1154) and hospital (81%, 962/1188) would use a diagnostic test in the case scenario of an infant with undifferentiated fever. Multilevel regression modelling showed that the country of work was more important in predicting both the availability and use of POCTs than individual or workplace characteristics.ConclusionThere is substantial variability in the adoption of POCTs for the management of acute infections in children across Europe. To inform future implementation of both existing and innovative tests, further research is needed to understand what drives the variation between countries, the needs of frontline clinicians, and the role of diagnostic tests in the management of acute childhood infections.

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Project description:Food allergy is an emerging clinical condition in pediatrics, so recommendations on its management have been widely published. Studying pediatricians' adherence to these clinical practice guidelines (CPG) and understanding the reasons for their non-compliance can help to promote better management of this condition. A cross-sectional study was conducted by a survey among Brazilian pediatricians, randomly selected during the 38th Brazilian Congress of Pediatrics, which took place in October, 2017. A validated questionnaire with 16 questions addressing knowledge and practice on food allergy, as well as self-reported adherence to international guidelines was applied. Of the total of 415 pediatricians from all regions of the country who were surveyed, only 69 (16.7%) had a satisfactory adherence rate (?80%). Adequate adherence to the guidelines was associated with the variables: 'evaluating more than 10 children with suspected cow's milk allergy (CMA) per month'; 'having read the Brazilian consensus'; or 'being aware of any international food allergy guideline'. In 8 of the 10 questions that assessed conscious adherence, a minority of those surveyed (20.3-42.3% variation) stated that they knew that their response was in line with the guidelines. This finding was statistically significant (p<0.05) in 7 of these 8 questions. The self-reported adherence of Brazilian pediatricians to international food allergy guidelines was low. Pediatricians who evaluated a higher number of children with suspected CMA or who were aware of the recommendations, had a higher rate of adherence. The results of the survey found that lack of resource was the major reported barrier to guideline adherence but lack of awareness must be a relevant non perceived barrier. This study shows the pediatricians´ self-reported adherence to food allergy guidelines in a widely overview for the first time in Brazil. More studies are necessary to investigate adherence to guidelines by pediatricians in other countries and to develop strategies to improve adherence.

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Dataset Information

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

Publications

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

Similar Datasets

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