title: Over-the-counter medication use for childhood fever: a cross-sectional study of Australian parents.
abstract: OBJECTIVE
  To report Australian parents' medication (paracetamol, ibuprofen and homeopathic) use in childhood fever management.
  
  
  METHODS
  A cross-sectional survey of 401 Queensland parents of children aged between 6 months and 5 years recruited through advertising (48.4%), face-to-face (26.4%) and snowball (24.4%) methods was conducted. A 17-item instrument was developed; construct and content validity were determined by an expert panel; and item reliability by test-retest with nine parents. Areas targeted were medication use and influences on and barriers to medication use.
  
  
  RESULTS
  Most participants were female, had tertiary education and lived in a major city (mean age 34.6 years). Reducing children's fever with over-the-counter medications was common (91%): 94% of parents reported using paracetamol and 77% reported using ibuprofen. A few (3.7%) used homeopathic remedies. Dosage was determined by weight (86.3%), age (84.3%), temperature (32.4%), illness severity (31.4%) and lethargy (20.9%). Frequency was determined by instructions on the medication label (55.3%), temperature (40.6%) and well-being (27.7%). Ibuprofen was administered too frequently by 31.5% (four hourly by 22.8%), and paracetamol by 3.8%. Fifty-two per cent had alternated medications, 65.8% of these for temperatures below 38.5 degrees C. Decisions to alternate were influenced by information from doctors/hospitals (49.5%) and children remaining febrile post-antipyretic (41.7%). Most parents reported over-the-counter medications as potentially harmful (73.2%), citing liver (38.2%), stomach (26.4%) and kidney (18.6%) damage and overdose (35.7%) as concerns. When medications were refused or spat out (44.0%), parents used force (62.4%), different methods (29.5%) or suppositories (20.8%).
  
  
  CONCLUSIONS
  Most parents used over-the-counter medications to reduce fever, often below 38.5 degrees C. The belief that these medications were harmful was overridden by fears of harmful outcomes from fever.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. am.walsh@qut.edu.au
authors.forename: Anne
authors.initials: A
authors.lastname: Walsh
authors.forename: Helen
authors.initials: H
authors.lastname: Edwards
authors.forename: Jenny
authors.initials: J
authors.lastname: Fraser
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005334:Fever / Q000188:drug therapy*; D005571:Formularies, Homeopathic as Topic; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010290:Parents / Q000523:psychology*; D011793:Queensland; D011795:Surveys and Questionnaires
chemical_list: D018712:Analgesics, Non-Narcotic; D004366:Nonprescription Drugs; D000082:Acetaminophen; D007052:Ibuprofen