International Journal of Clinical Pharmacy

, Volume 38, Issue 4, pp 761–770 | Cite as

Drivers for inappropriate fever management in children: a systematic review

  • M. KellyEmail author
  • S. McCarthy
  • R. O’Sullivan
  • F. Shiely
  • P. Larkin
  • M. Brenner
  • L. J. Sahm
Review Article


Background Fever is one of the most common childhood symptoms and accounts for numerous consultations with healthcare practitioners. It causes much anxiety amongst parents as many struggle with managing a feverish child and find it difficult to assess fever severity. Over- and under-dosing of antipyretics has been reported. Aim of the review The aim of this review was to synthesise qualitative and quantitative evidence on the knowledge, attitudes and beliefs of parents regarding fever and febrile illness in children. Method A systematic search was conducted in ten bibliographic databases from database inception to June 2014. Citation lists of studies and consultation with experts were used as secondary sources to identify further relevant studies. Titles and abstracts were screened for inclusion according to pre-defined inclusion and exclusion criteria. Quantitative studies using a questionnaire were analysed using narrative synthesis. Qualitative studies with a semi-structured interview or focus group methodology were analysed thematically. Results Of the 1565 studies which were screened for inclusion in the review, the final review comprised of 14 studies (three qualitative and 11 quantitative). Three categories emerged from the narrative synthesis of quantitative studies: (i) parental practices; (ii) knowledge; (iii) expectations and information seeking. A further three analytical themes emerged from the qualitative studies: (i) control; (ii) impact on family; (iii) experiences. Conclusion Our review identifies the multifaceted nature of the factors which impact on how parents manage fever and febrile illness in children. A coherent approach to the management of fever and febrile illness needs to be implemented so a consistent message is communicated to parents. Healthcare professionals including pharmacists regularly advise parents on fever management. Information given to parents needs to be timely, consistent and accurate so that inappropriate fever management is reduced or eliminated. This review is a necessary foundation for further research in this area.


Attitudes Children Fever Fever management Knowledge Parents 



MK is an Honorary Research Fellow at the Health Research Board Clinical Research Facility, Cork (CRF-C), Ireland. We would like to acknowledge the assistance of Professor Joe Eustace, Director CRF-C, who supplemented training and publication costs for this study. We would also like to acknowledge the support of Mr Joe Murphy (Librarian, Mercy University Hospital, Cork, Ireland) who assisted with search design.


No funding was received to conduct this study.

Conflicts of interest

The authors have no relevant competing interests to declare.

Supplementary material

11096_2016_333_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 13 kb)


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Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • M. Kelly
    • 1
    Email author
  • S. McCarthy
    • 1
    • 2
  • R. O’Sullivan
    • 3
    • 4
  • F. Shiely
    • 5
  • P. Larkin
    • 6
  • M. Brenner
    • 6
  • L. J. Sahm
    • 1
    • 7
  1. 1.Pharmaceutical Care Research Group, School of PharmacyUniversity College CorkCorkIreland
  2. 2.Department of PharmacyCork University HospitalCorkIreland
  3. 3.School of MedicineUniversity College CorkCorkIreland
  4. 4.National Children’s Research CentreDublinIreland
  5. 5.HRB Clinical Research Facility & Department of Epidemiology and Public HealthUniversity College CorkCorkIreland
  6. 6.School of Nursing, Midwifery and Health SystemsUniversity College DublinDublinIreland
  7. 7.Mercy University HospitalCorkIreland

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