Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 22, 2020
Date Accepted: Apr 11, 2021
Comparative analysis of single and combined antipyretics using patient-generated health data: A retrospective observational study
ABSTRACT
Background:
Although fever is one of the most common symptoms in children and is the physiological response of the human immune system to external pathogens, the effectiveness studies of single and combined antipyretic therapy are relatively less due to lack of data. In this study we used large-scale patient-generated health data (PGHD) from mobile applications to compare antipyretic affects between single and combination antipyretics.
Objective:
We aimed to compare antipyretic affects between single and combination antipyretics using large-scale patient-generated health data from mobile applications.
Methods:
This study was conducted using records for feverish children from July 2015 to June 2017 using the Fever Coach mobile application. Totally, 3,584,748 temperature records and 1,076,002 antipyretic records in 104,337 children were analyzed. Antipyretic efficacy was measured by the mean difference in the area under the temperature change curve (AUC) from baseline for 6, 8, 10, and 12 hours after antipyretics between single and combination groups.
Results:
The single antipyretic group comprised 152,017 cases, and the combination group comprised 54,842 cases. Acetaminophen was the most used single agent (40.1%), and acetaminophen plus dexibuprofen was the most common combination (51.3%). There were inappropriate usages, including triple combination (0.6%) and use under 38℃ (5.5%). Combination antipyretic use increased with temperature; 23.8% of cases used a combination treatment when 38℃ ≤ temperature < 39℃, while 41.4% used a combination treatment when 40℃ ≤ temperature. The absolute value of AUC at each hour was significantly higher in the single than in the combination group; this trend was consistently observed, regardless of the type of antipyretics. In particular, the delta fever during the first 6 hours between the two groups showed the highest difference. The triple combination showed the lowest delta fever among all cases.
Conclusions:
Combination antipyretics did not have favorable effects, regardless of the combination. Single antipyretics would be effective to reduce fever and relieve discomfort in febrile children.
Citation
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