PARENTS BURDEN OF PEDIATRIC INFLUENZA AS A CAREGIVER AND THEIR EXPECTATION TO RECEIVE ANTIBIOTIC PRESCRIPTIONS FOR THEIR CHILDREN – A PILOT STUDY AT A PEDIATRIC CLINIC

Purpose:

Pediatric influenza can place significant burden on caregivers. The specific aim of our research was to estimate the contribution of a parent’s perceived burden as a caregiver on their level of expectations to receive antibiotic prescriptions for their influenza infected child.

Method:

A prospective study was conducted using a self-administered survey of parents at West Virginia University Pediatric Clinic, Morgantown, WV. Parents of children (age ≤ 5 years) who are suffering from influenza/influenza like illnesses (ILI) were considered for this study. Parents of those children without chronic medical conditions perceived by parents but with signs and/or symptoms of influenza perceived by the parents were recruited for this study at the patient waiting room. A data collection instrument was prepared using pre-validated questionnaires. The Modified Caregiver Strain Index (MCSI), a 13 items tool that measures strain (major domains: financial, physical, psychological, social, and personal) related to care provision was used to measure caregiver burden. Parents’ expectation to receive antibiotic prescription was measured on a scale of 0 (‘No Expectation’) to 100 (‘High Expectation’); a 100mm visual-analog-scale was used for this purpose. Socio-demographic information of the parents and their knowledge related to antibiotic use was also measured. Descriptive and multivariable regression analyses were performed using SAS^®9.3 (significance level = 0.05).

Result:

A total of 53 completed surveys were analyzed. Mean age of the sample was 30.3±7 years and 75% of them were female. The median expectation score to receive antibiotic prescription for children was 50 on a scale of 0 to 100. Unadjusted correlation analysis revealed that parents’ expectation for antibiotic prescription was highly correlated (correlation coefficient = 0.75, p <0.0001) with the burden a parent perceived as a caregiver when the child was suffering from influenza/ILI. Covariate adjusted multivariable regression analysis indicated that caregiver burden was the most influencing predictor (p<0.0001) of parents’ expectation for antibiotic expectation. The only covariate which has significant effect (p=0.03) on expectation was parents’ believe that “in the past they have received antibiotic prescription for their children because they requested it from their pediatricians”.

Conclusion:

There was significant effect of perceived caregiver burden on parents’ expectation to receive antibiotic prescription for their children.  Policy makers and intervention programs should consider this factor to boost effective reduction of antibiotic expectations.