Assessing the appropriateness of the management of otitis media in Australia: A population-based sample survey

被引：3

作者：

Clay-Williams, Robyn ^{[1
]}

Stephens, Jacqueline H. ^{[3
]}

Williams, Helena ^{[4
]}

Hallahan, Andrew ^{[5
,6
]}

Dalton, Chris ^{[2
]}

Hibbert, Peter ^{[1
,3
]}

Ting, Hsuen P. ^{[1
]}

Arnolda, Gaston ^{[1
]}

Wiles, Louise ^{[3
]}

Braithwaite, Jeffrey ^{[1
]}

Jaffe, Adam ^{[7
,8
]}

White, Les ^{[9
,10
,11
]}

Cowell, Christopher T. ^{[12
,13
]}

Harris, Mark F. ^{[14
]}

Runciman, William B. ^{[9
,15
,16
]}

Wheaton, Gavin ^{[17
]}

Murphy, Elisabeth ^{[18
]}

Molloy, Charlotte J. ^{[9
,15
]}

Ramanathan, Shanthi ^{[9
,15
]}

Hooper, Tamara D. ^{[9
,15
]}

Szabo, Natalie ^{[9
,15
]}

Wakefield, John G. ^{[19
]}

Hughes, Clifford F. ^{[9
,20
]}

Schmiede, Annette ^{[21
]}

Dalton, Sarah ^{[11
,22
]}

Holt, Joanna ^{[9
]}

Donaldson, Liam ^{[23
,24
]}

Kelley, Ed ^{[24
]}

Lilford, Richard ^{[25
]}

Lachman, Peter ^{[20
]}

Muething, Stephen ^{[26
]}

机构：

[1] Macquarie Univ, Ctr Healthcare Resilience & Implementat Sci, Australian Inst Hlth Innovat, Level 6,75 Talavera Rd, Macquarie Pk, NSW 2109, Australia

[2] Bupa ANZ, Sydney, NSW, Australia

[3] Univ South Australia, Sch Hlth Sci, Adelaide, SA, Australia

[4] Southern Adelaide Local Hlth Network, Adelaide, SA, Australia

[5] Univ Queensland, Queensland Childrens Hosp, Childrens Hlth Queensland, Brisbane, Qld, Australia

[6] Univ Queensland, Sch Med, Brisbane, Qld, Australia

[7] Univ New South Wales, Sch Womens & Childrens Hlth, Sydney, NSW, Australia

[8] Sydney Childrens Hosp Network, Sydney Childrens Hosp, Dept Resp Med, Sydney, NSW, Australia

[9] Macquarie Univ, Ctr Healthcare Resilience & Implementat Sci, Australian Inst Hlth Innovat, Sydney, NSW, Australia

[10] Univ New South Wales, Sch Womens & Childrens Hlth, Discipline Paediat, Sydney, NSW, Australia

[11] Sydney Childrens Hosp Network, Sydney Childrens Hosp, Sydney, NSW, Australia

[12] Sydney Childrens Hosp Network, Kids Res Inst, Sydney, NSW, Australia

[13] Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia

[14] Univ New South Wales, Fac Med, Ctr Primary Hlth Care & Equ, Sydney, NSW, Australia

[15] Univ South Australia, Ctr Populat Hlth Res, Sansom Inst Hlth Res, Adelaide, SA, Australia

[16] Australian Patient Safety Fdn, Adelaide, SA, Australia

[17] Womens & Childrens Hosp, Div Paediat Med, Adelaide, SA, Australia

[18] New South Wales Minist Hlth, Sydney, NSW, Australia

[19] Queensland Dept Hlth, Clin Excellence Div, Brisbane, Qld, Australia

[20] Int Soc Qual Hlth Care, Dublin, Ireland

[21] Bupa Hlth Fdn Australia, Sydney, NSW, Australia

[22] New South Wales Agcy Clin Innovat, Sydney, NSW, Australia

[23] London Sch Hyg & Trop Med, London, England

[24] WHO, Geneva, Switzerland

[25] Univ Warwick, Coventry, W Midlands, England

[26] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA

来源：

JOURNAL OF PAEDIATRICS AND CHILD HEALTH | 2020年 / 56卷 / 02期

基金：

英国医学研究理事会;

关键词：

acute otitis media; otitis media; otitis media with effusion; patient safety; RESPIRATORY-TRACT INFECTIONS; PRIMARY-HEALTH-CARE; ANTIBIOTIC PRESCRIPTION; TREATMENT GUIDELINES; PRESCRIBING RATES; DECISION-SUPPORT; GENERAL-PRACTICE; FOLLOW-UP; CHILDREN; ADHERENCE;

D O I：

10.1111/jpc.14560

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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.

引用

页码：215 / 223

页数：9

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