The effect of the guidelines for management of febrile seizures 2015 on clinical practices: Nationwide survey in Japan |
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| Affiliation: | 1. Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan;2. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan;3. Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan;4. Division of Neurology, Saitama Children′s Medical Center, Saitama, Japan;5. Fukuyama Support Center of Development and Care for Children, Fukuyama, Japan;6. Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan;7. Division of Neurology, National Center for Child Health and Development, Tokyo, Japan;8. Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan;9. Department of Pediatrics, Juntendo University Nerima Hospital, Tokyo, Japan;10. Tanabe Children′s Clinic, Osaka, Japan;11. Department of Child Neurology, Okayama University Graduate Schools of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan;12. Department of Public Health, Tokyo Women′s Medical University, Tokyo, Japan;13. Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan;14. Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan;15. Division of Child Neurology, Faculty of Medicine, Tottori University, Tottori, Japan;p. Faculty of Health and Medical Sciences, Tokoha University Hamamatsu Campus, Hamamatsu, Japan;1. Department of Internal Medicine, Fukuwatari Municipal Hospital, Okayama, Japan;3. Department of Internal Medicine, Nippon Kokan Fukuyama Hospital, Fukuyama, Japan;4. Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan;6. Department of Surgery, Nippon Kokan Fukuyama Hospital, Fukuyama, Japan;5. Department of Bacteriology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan;1. Department of Pediatric Intensive Care, Nagano Children’s Hospital, Azumino, Japan;2. Division of Neurology, Nagano Children’s Hospital, Azumino, Japan;3. Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan;1. Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan;2. Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan;3. Yokohama Medical and Welfare Centre, Konan, Yokohama, Japan;4. Department of Child Neurology, Seirei-Hamamatsu General Hospital, Hamamatsu, Japan;1. Karadeniz Technical University, School of Medicine, Department of Child Neurology, Trabzon, Turkey;2. Hacettepe University, School of Medicine, Department of Child Neurology, Ankara, Turkey;3. Yıldırım Beyazıt University, Atatürk Hospital, Department of Medical Genetics, Ankara, Turkey;1. Department of Pediatric Neurology, Akdeniz University School of Medicine, Antalya, Turkey;2. Department of Pediatric Neurology, Ankara Children’s Hospital Hematology-Oncology Research and Training Hospital, Ankara, Turkey;1. Division of Neurology, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan;2. Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;3. Department of Epidemiology, UCLA Fielding School of Public Health, LA, CA, USA;4. Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan;5. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan;6. Division of Pediatric Neurology, Department of Pediatrics, UCLA Medical Center, LA, CA, USA;7. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Japan;8. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan |
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| Abstract: | ObjectiveTo investigate the effect of guidelines for management of febrile seizures on the clinical practice, we conducted a nationwide survey in Japan.MethodsThe Japanese guidelines for management of febrile seizures 2015 (GL2015) was released in 2015. In 2016, a questionnaire was sent to all 512 certified hospitals (3 pediatricians each) of the Japan Pediatric Society and all 47 prefecture Pediatric Associations (10 private pediatricians each) in Japan asking about management policies for febrile seizures (FSs) during 2013–2014 and 2016. The questionnaires were about the following procedures: (1) lumbar punctures, blood examinations, and diazepam suppositories for children after a first simple FS at emergency departments; and (2) prophylactic diazepam during febrile illnesses in children with two or three past simple FSs, with no known predictors of recurrence.ResultsA total of 1327 pediatricians (66.2%) answered the questionnaire. Numbers of pediatricians performing lumbar punctures and blood examinations, and giving diazepam suppositories after a first simple FS were less in 2016 than in 2013–2014 (1.2% and 2.0%, 53.1% and 61.3%, and 36.7% and 51.9%, respectively). Pediatricians recommending prophylactic diazepam for children with two and three FSs decreased from 45.7% and 82.4% in 2013–2014 to 31.0% and 65.0% in 2016, respectively.ConclusionGL2015 had an effect on the clinical practices of pediatricians. On the other hand, 65% recommended prophylactic diazepam to children with three simple FSs even though GL2015 did not recommend use of diazepam based on number of previous FS. Anxiety about frequent seizures may affect pediatricians′ clinical practice. |
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