Assessing the appropriateness of the management of otitis media in Australia: A population-based sample survey
Autor: | Louise Wiles, Hsuen P Ting, Andrew R. Hallahan, Peter Hibbert, Jacqueline H. Stephens, Jeffrey Braithwaite, Robyn Clay-Williams, Chris Dalton, Gaston Arnolda, Helena Williams |
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Přispěvatelé: | Clay-Williams, Robyn, Stephens, Jacqueline H, Williams, Helena, Hallahan, Andrew, Dalton, Chris, Hibbert, P, Ting, HP, Arnolda, G, Wiles, L, Braithwaite, J, CareTrack Kids Investigative Team |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Acute otitis media General Practice Clinical decision support system 03 medical and health sciences Patient safety 0302 clinical medicine Antibiotic resistance 030225 pediatrics otorhinolaryngologic diseases patient safety Humans Medicine otitis media with effusion 030212 general & internal medicine Child Otitis Media with Effusion business.industry Medical record acute otitis media Australia Infant Anti-Bacterial Agents Otitis Media Otitis Infectious disease (medical specialty) Child Preschool Family medicine Acute Disease Pediatrics Perinatology and Child Health Ambulatory Guideline Adherence medicine.symptom business |
Popis: | Aim: Acute otitis media (AOM) is the most common infectious disease for which antibiotics are prescribed; its management is costly and has the potential to increase the antimicrobial resistance of this infection. This study measured the levels of adherence to the clinical practice guidelines (CPGs) of AOM and otitis media with effusion (OME) management in Australian children. Methods: We searched for national and international CPGs relating to AOM and OME in children and created 37 indicators for assessment. We reviewed medical records for adherence to these indicators in 120 locations, across one inpatient and three ambulatory health-care settings. Our review sample was obtained from three Australian states that contain 60% of the nation's children. Results: We reviewed the records of 1063 children with one or more assessments of CPG adherence for otitis media. Of 22 indicators with sufficient data, estimated adherence ranged from 7.4 to 99.1%. Overuse of treatment, particularly overprescribing of antibiotics, was more common than underuse. A frequent lack of adherence with recommended care was observed for children aged between 1 and 2 years with AOM. Adherence varied by health-care setting, with emergency departments and inpatient settings more adherent to CPGs than general practices. Conclusions: Our assessment of a number of indicators in the common settings in which otitis media is treated found that guideline adherence varied widely between individual indicators. Internationally agreed standards for diagnosis and treatment, coupled with clinician education on the existence and content of CPGs and clinical decision support, are needed to improve the management of children presenting with AOM and OME Refereed/Peer-reviewed |
Databáze: | OpenAIRE |
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