Eefje de Bont

Project title
The CHILI study: Optimizing management and medication of febrile children in out-of-hours primary care

Dr. Jochen W.L. Cals and Prof. Dr. Geert-Jan Dinant

Fever is the most common reason for a child to be taken to the general practitioner (GP). During out-of-hours care. In most cases, fever is caused by a benign (viral) infection and general recommendations given by the GP are sufficient. However, one-third of febrile children receive antibiotics whilst this is often unnecessary and not recommended in guidelines. GPs aim to avoid unnecessary treatment and prescription of medication but also try to avoid sending children that require treatment home untreated. On the other hand, parents visit a GP or GP out-of-hours centre often due to concerns about harmful consequences of fever, such as febrile convulsions, death, dehydration, or serious infections. In many cases these concerns are the result of a lack of experience and knowledge about fever. A rising temperature but also conflicting information about how to manage fever raises concerns among parents. A GP-parent information exchange tool in the form of an interactive booklet can provide parents with information about symptoms and fever management and consistent information during GP consultations. Thereby enhancing their self-management and providing a safety-net when they return home. It is hypothesized that the use of interactive booklet at out-of-hours GP centres will result in a reduced number of antibiotic prescriptions, improved parental satisfaction and reduced intention to re-consult. Based on existing guidelines, expert opinions and qualitative research we developed this interactive booklet. The next step will be to perform a cluster randomized controlled trial (RCT) in 2015-2016 to evaluate the effectiveness of a GP-parent information exchange tool (interactive booklet) during consultations with febrile children aged 3 months to 12 years old at GP out-of-hours centres.