Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Center for Clinical Epidemiology and Outcomes Research, Athens, Greece.
Eur J Pediatr. 2023 Jul;182(7):3293-3300. doi: 10.1007/s00431-023-05004-1. Epub 2023 May 9.
The purpose of this study was to investigate knowledge, principles, and practices concerning the management of children with febrile seizures among pediatricians in Greece. A cross-sectional study was performed across Greece. Pediatricians completed an anonymous and voluntary 11-item questionnaire about their knowledge, attitudes, and practices with respect to the management of febrile seizures; the survey also collected demographic data. It was first administered in paper form in October 2017. This was followed by an online survey performed between June and August of 2018 and publicized by medical boards across Greece. Descriptive statistics and comparisons between groups were conducted with the significance level set at p ≤ 0.05. We recorded 457 responses. Pediatricians admitted to modifying their advice to the parents of children with febrile seizures by suggesting more "aggressive" fever management at low temperatures or systematically (63%), referral to a specialist after any episode of febrile seizures (63%), or hospitalization in a subsequent episode (67%), even though 72% admitted these practices were of no efficacy. Almost one in three pediatricians (28%) believed aggressive management of fever could delay the onset of febrile seizures; increasing age was associated with this perception. A minority (28%) would make parents aware of febrile seizures before a first episode regardless of family history; 38% would do so in the event of family history.
Several pediatricians in Greece use outdated and ineffective practices for the management of febrile seizures, despite the availability of updated evidence-based guidelines. Further training of practitioners is needed to bridge this gap.
•Aggressive management of fever at low temperatures with antipyretics, referral to a neurologist, and hospitalization are not supported by evidence or recent guidelines on childhood febrile seizures. •Febrile seizures are especially disturbing to uninformed parents, who may be inclined to pursue aggressive but ineffective treatments as a result.
•Pediatricians in Greece use non-evidence-based practices for the management of febrile seizures, even when they are aware that these practices are not effective. •Older age increases the likelihood that a pediatrician will pursue guideline non-compliant practices in Greece. At the same time, physicians with over 20 years of experience are more likely to inform parents in advance about febrile seizures.
本研究旨在调查希腊儿科医生对热性惊厥管理的知识、原则和实践。方法：采用横断面研究，在希腊进行。儿科医生完成了一份关于其管理热性惊厥的知识、态度和实践的匿名、自愿的 11 项问卷；调查还收集了人口统计学数据。该问卷于 2017 年 10 月首次以纸质形式发放。随后，于 2018 年 6 月至 8 月进行了在线调查，并由希腊各地的医学委员会进行了宣传。采用描述性统计和组间比较，显著性水平设为 p ≤ 0.05。结果：我们记录了 457 份答卷。儿科医生承认，他们会根据需要调整对热性惊厥患儿家长的建议，例如在体温较低时或系统地建议更“积极”地控制发热（63%），建议在任何热性惊厥发作后转介给专家（63%），或在后续发作时住院（67%），尽管 72%的医生承认这些做法没有效果。近三分之一的儿科医生（28%）认为积极控制发热可能会延迟热性惊厥的发作；年龄较大与这种观念相关。尽管有更新的基于证据的指南，但只有少数儿科医生（28%）会在首次发作前让家长了解热性惊厥；38%会在有家族史的情况下这样做。结论：尽管有更新的基于证据的热性惊厥管理指南，但希腊的一些儿科医生仍在使用过时且无效的实践方法。需要对从业者进行进一步的培训以缩小这一差距。
