Incorporating patient preferences into practice guidelines: management of children with fever without source.

STUDY OBJECTIVE

To evaluate parent preferences for the therapy of young children with fever without source.

PARTICIPANTS

Consecutive parents, not in a medical profession, of children less than 36 months old.

SETTING

Pediatric clinic of a university teaching hospital.

DESIGN

During individual interviews at the time of their child's clinic visit, parents were presented with a case scenario and two treatment options and the risks, outcomes, and cost associated with each.

MAIN OUTCOME MEASURE

Parent preferences for alternative treatment strategies.

RESULTS

All parents correctly identified the management strategy with the higher probability of an adverse outcome. Seventy-one percent chose the option with less testing and treatment and the greater risk of an adverse outcome. Parents' reasons for this choice were fewer painful tests and procedures (36%), less time waiting (32%), smaller chance of unnecessary antibiotics (23%), and ability to return if their child's condition deteriorated (22%). Thirty-two percent of parents indicated that cost was a factor in their decision. Age, gender, education, and/or number of children was not associated with parents' treatment preferences.

CONCLUSION

Parents' preferences may be considered when determining how to manage febrile infants and children.