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Management of drooling in children: a survey of UK paediatricians' clinical practice

Authors


  • Members of the British Academy of Childhood Disability Drooling Study Development Group include: J. R. Parr, L. Pennington, C. A. Buswell, E. Honey and A. Colver, Newcastle University

  • J. Williams, Nottingham University Hospitals NHS Foundation Trust

  • C. Fairhurst and H. Cockerill, Guy's and St Thomas' NHS Foundation Trust

  • A. O'Hare, Edinburgh University, M. A. Andrew, University of Oxford

  • K. Banerjee, South Birmingham Primary Care Trust

Jeremy Parr, Institute of Neuroscience, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK. E-mail: jeremy.parr@ncl.ac.uk

Abstract

Background  Drooling is common in children with disordered oral-motor control. There is little evidence about the comparative effectiveness of different interventions used to reduce the impact of drooling. Anecdotal reports suggest clinicians' management of drooling varies widely. The aims of this survey were to establish which drooling interventions are currently used, how their effectiveness is monitored and how frequently adverse effects are reported.

Methods  151 UK paediatricians completed a questionnaire about their management of drooling.

Results  Paediatricians saw one new child with problematic drooling and three follow-up children per month. The most common prescribing pattern was hyoscine first line (84.7%) followed by glycopyrronium bromide second line. The reported rate of adverse effects of medications was lower than expected (median 10% for hyoscine). Very few paediatricians used standardized methods of measuring the medication's effectiveness or adverse effects.

Conclusion  Paediatricians regularly see small numbers of children with problematic drooling. Their clinical management of drooling varies; this is most likely because of a lack of evidence about the most effective approach. Comparative trials of interventions and the development of evidence-based clinical guidelines would improve the management of children's drooling.

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