Australian Doctor Australian Doctor 15th September 2017 | Page 3

GPs slam ‘parental trust’ study
MICHAEL WOODHEAD
GPs have questioned the agenda of
Victorian researchers who claimed
parents lack confidence in GPs to
manage childhood illnesses.
Paediatrician Dr Gary Freed and
colleagues from the University of
Melbourne gained widespread
media coverage last week, with
survey results that showed only
44% of parents were “completely
confident” in GPs to manage gen-
eral health issues in children.
Dr Freed said the low levels of
confidence reported by parents
might explain why they took their
children to EDs rather than to a
GP for minor illness.
He said the findings suggested
that GP registrars needed more
exposure to training in paediatrics.
However,
GPs
including
RACGP president Dr Bastian Sei-
del were quick to respond online,
saying the study was biased and
misinterpreted data from the 2100
parents.
GPs claimed the authors played
down the fact that a further 45%
of respondents said they were
“mostly confident” that GPs could
handle general health issues.
Only 2% of parents said they
were “not very” confident.
Rather than showing a need
ANTONY SCHOLEFIELD
‘If GPs can get ahead
of the problem, they
can and should be the
leaders in figuring out
how to fix it.’
— Paediatrician Dr Gary
Freed, University of
Melbourne
for more training in paediatrics,
the take-home message was that
parental confidence was greater
for families who had a regular GP,
they said.
When contacted by Australian
Doctor, Dr Freed said he under-
stood the sensitivities of GPs.
However
the
researchers
believed it was a reasonable expec-
tation for GPs to have the confi-
dence of parents to handle almost
all general health issues rather
than just most of them.
The findings also had to be seen
in the context of previous research
showing that parents were taking
their children to EDs for low-acu-
ity conditions, he added.
“Although I understand this
study was more personal to
many GPs, I hope this provides
an opportunity for the GP com-
munity to take a closer look at all
of the data published on this issue
and begin to address these worri-
some concerns regarding the care
of children.
“I believe GPs are the best peo-
ple in the Australian healthcare
system to provide primary care
— they just need the training and
support to do it. If GPs can get
ahead of the problem, they can
and should be the leaders in fig-
uring out how to fix it,” said Dr
Freed.
Journal of Paediatrics and Child
Health 2017; online.
Query over antidepressants in pregnancy
JOCELYN WRIGHT
CHILDREN exposed to
antidepressants in pregnancy may
be at increased risk of developing
a psychiatric disorder in later life, a
study suggests.
But whether the higher rates of
mood disorders and other psychiatric
conditions in offspring are related
to antidepressants or the mother’s
Moisturiser
claims jar
mental illness is a hotly debated
question following a study of 900,000
Danish children up to the age of 16.
The overall incidence of psychiatric
disorders among unexposed children
was 8% compared with 13% for
children of mothers who continued
antidepressants in pregnancy, 14%
for those who started antidepressants
in pregnancy and 11% for women
who discontinued antidepressants in
pregnancy. Children of women who
continued using antidepressants in
pregnancy had a threefold higher risk
of mood disorders compared with
children of women who discontinued
antidepressants during pregnancy.
“From a public health perspective,
this indicates that 0.5% of psychiatric
disorders in our population could
have been prevented if mothers in the
antidepressant continuation group
had not taken antidepressants during
pr egnancy,” the authors claimed.
However, the association “may
be attributable to the severity of
underlying maternal disorders in
combination with antidepressant
exposure in utero”, they said.
PATIENTS who need moisturiser
for conditions such as atopic
dermatitis should not trust
expensive products claiming to be
hypoallergenic or fragrance free,
dermatologists say.
A US study of 174 best-selling
moisturisers found more than
80% labelled as hypoallergenic
contained at least one allergen
according to North American
Contact Dermatitis Group
definitions. Likewise, almost half
of creams labelled ‘fragrance free’
contained fragrance allergens or
cross-reactive ingredients.
Moisturisers with such claims
were 33% more costly than other
products, but the claims were
mostly marketing tools, said the
researchers from the department
of dermatology at Northwestern
University in Illinois, US.
An accompanying editorial said
patients could not trust the terms
‘hypoallergenic’ or ‘fragrance free’.
Moves by the US Food and Drug
Administration to set standards for
the term hypoallergenic had been
overturned by legal action from the
cosmetic industry, it noted.
“Thus for the foreseeable future,
dermatologists and patients will
need to continue to practise
vigilance when it comes to
selecting products that are of low
allergenic potential.”
Dr Saxon Smith of the
Australasian College of
Dermatologists agreed with
the findings. The best protocol
for patients when choosing a
moisturiser was to test individual
products on a small patch of skin,
twice a day for two weeks to check
for reactions, he said.
JAMA Dermatology 2017; online.
BMJ 2017; online.
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15 September 2017 | Australian Doctor |
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