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PEDIATRICS Vol. 108 No. 5 November 2001, pp. 1080-1088

Treatment of Febrile Seizures: The Influence of Treatment Efficacy and Side-Effect Profile on Value to Parents

Received Nov 21, 2000; accepted Apr 18, 2001.

Kevin E. Gordon*, Dagger , Joseph M. Dooley*, Dagger , Peter R. Camfield*, Dagger , Carol S. Camfield*, Dagger , and Judith MacSween*

From the * IWK Health Center, Dagger  Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.

Objectives.  We examined parents' perception of the value of treatments designed to reduce the risk of febrile seizure recurrence.

Study Design.  The families of 42 children with febrile seizures were recruited after pediatric or neuropediatric consultation. A mail questionnaire addressed the family's willingness to pay for a hypothetical treatment for febrile seizures with risk reductions for future febrile seizures of 25%, 50%, 75%, and 100%. The hypothetical clinical scenario was then modified to include the side- effect profiles of either daily phenobarbital or valproic acid, or intermittent diazepam prophylaxis. Covariates included the nature of the child's febrile seizure(s), parents' familiarity with febrile seizures, experiences at the time of febrile seizures or with medication side effects, education and income, and mastery and trait anxiety.

Results.  Thirty-eight parents, representing 22 of 42 families, completed questionnaires. There was a dramatic inflection in parents' willingness to pay for 100% risk reduction as opposed to 75% or lower risk reductions. Introduction of side effects dramatically reduced the value attached to each level of treatment benefit. Nevertheless, a few parents (3/38) would pay "as much as it takes" to be rid of their child's recurrence risk.

Conclusions.  Given the range of value assigned to prophylactic medication for febrile seizures, management strategies for children with febrile seizures must be responsive to the needs and values of individual families.  Key words:  febrile seizures, treatment, willingness to pay, parent attitudes, shared decision-making.




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