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What matters when managing childhood fever in the emergency department?

To determine the preferences of parents and health care providers (HCPs) for the management of paediatric febrile illness in the emergency department (ED), 98 parents of children aged 0-11 years and 99 HCPs at 10 children's centres and a children's ED in England were surveyed between June 2018 and January 2019.

Participants were asked to choose their preferred option of several hypothetical management scenarios, with differing levels of visit time, out-of-pocket costs, antibiotic prescribing, HCP grade and pain/discomfort from investigations.

Avoiding pain from diagnostics, receiving a faster diagnosis and minimising wait times were major concerns for both parents and HCPs.

Parents were willing to pay £16.89 for every hour reduction in waiting times.

Both groups preferred treatment by consultants and nurse practitioners to treatment by doctors in postgraduate training.

Parents were willing to trade-off considerable increases in waiting times (24.1 minutes) to be seen by a consultant and to avoid additional pain from diagnostics (45.6 minutes).

Reducing antibiotic prescribing was important to HCPs but not parents.

Presenting the findings in the Archives of Disease in Childhood, the authors say: “Because the availability of diagnostics is increasing, with CRP-POC testing now used in some UK primary care settings, the findings of this study may be used to prioritise the implementation of upcoming diagnostics, to best meet the preferences of families and HCPs.”


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