Volume : 12, Issue : 06, June – 2025
Title:
PHYSICIANS’ ADHERENCE TO CLINICAL GUIDELINES IN THE MANAGEMENT OF FEBRILE SEIZURES IN THE PEDIATRIC EMERGENCY DEPARTMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors :
Fatimah Alkhamis , Amjad Mustafa Altunusi , Mohammed Abdullah Salah Alharbi, Awn abdullah mohammed alkathiri , Ali Salem S Al Mannaa ,Abdulrahman Mohammed S AlMobty , Ibrahim abdulmonem almajed , Fatimah Sami Alkhalifah, Ekram Alkhalifah,Hussain Ali Hussain ALrashdi
Abstract :
Background: Febrile seizures are among the most common neurological presentations in pediatric emergency departments (PEDs). Despite the availability of evidence-based clinical guidelines, variations in practice persist, leading to unnecessary interventions and heightened parental anxiety.
Objective: To systematically review and analyze the existing literature regarding physicians’ adherence to clinical guidelines in the management of febrile seizures in pediatric emergency settings and to identify the most common deviations and contributing factors.
Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Databases including PubMed, Scopus, Web of Science, and Cochrane Library were searched from inception to March 2025. Studies reporting adherence to febrile seizure management guidelines by physicians in pediatric emergency departments were included. Data were extracted on adherence rates, guideline deviations, physician characteristics, and institutional practices. A random-effects meta-analysis was used to estimate pooled adherence rates and explore heterogeneity.
Results: Out of 1,148 articles screened, 19 studies met the inclusion criteria, encompassing a total of 5,632 pediatric febrile seizure cases. The pooled overall adherence rate was 62.5% (95% CI: 56.8–68.2%). Common deviations included unnecessary neuroimaging (28%, 95% CI: 23–33%), lumbar puncture in neurologically normal children (16%, 95% CI: 12–21%), and use of antiepileptic drugs in simple febrile seizures (11%, 95% CI: 7–14%). Subgroup analysis revealed higher adherence among pediatric emergency specialists (76%) compared to general physicians (49%). The use of clinical decision support tools and adherence checklists was associated with significantly improved compliance.
Conclusion: This systematic review and meta-analysis highlight a moderate but suboptimal adherence to febrile seizure guidelines in pediatric emergency settings. Interventions such as continuous medical education, institutional protocols, and parental counseling are essential to bridge the gap between evidence-based guidelines and clinical practice.
Cite This Article:
Please cite this article in press Fatimah Alkhamis et al., Physicians’ Adherence To Clinical Guidelines In The Management Of Febrile Seizures In The Pediatric Emergency Department: A Systematic Review And Meta-Analysis, Indo Am. J. P. Sci, 2025; 12(07)..
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