Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children

Sibthorpe, Beverly; Agostino, Jason; Coates, Harvey; Weeks, Sharon; Lehmann, Deborah; Wood, Marianne; Lannigan, Francis J.; McAullay, Daniel

doi:10.1071/py16096

Cited by 13 publications

(10 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although most commonly a benign condition, AOM is associated with sequelae such as otorrhea, perforation of the tympanic membrane, chronic suppurative otitis media and, rarely, mastoiditis . Episodes of AOM are associated with fluctuating mild to moderate conductive hearing loss, leading to potential deficits in language and developmental delay …”

mentioning

confidence: 99%

Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

Balasundaram

Phan

Mazzoni

et al. 2019

J Paediatrics Child Health

View full text Add to dashboard Cite

Aim: To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines. Methods: We performed a retrospective descriptive cohort study of patients ≤15 years of age who presented to two EDs in Southeast Queensland between January 2016 and June 2017 with an ED diagnosis of AOM. Likelihood of diagnosis was based on medical records and classified as likely, possible or unlikely using paediatric practice guidelines. Appropriateness of antibiotics prescription was classified using the National Antibiotic Prescribing Survey, which takes into account adherence to the Australian Therapeutic Guidelines. Each medical record was extracted by two blinded reviewers, and discrepancies were resolved by consensus or arbitration. Results: Of the 305 patients included for analysis, 87% had a likely or possible diagnosis of AOM. Otalgia was the presenting complaint in 75%. Standard otoscopy was the routine method for tympanic membrane visualisation, and 70% had abnormal tympanic membrane findings. Almost two-thirds (62%) of all children were prescribed antibiotics. Antibiotic appropriateness could be ascertained for 286 patients (94%). A total of 39% received inappropriate antibiotic management for AOM. The majority of patients received analgesia in the form of paracetamol and/or ibuprofen. Conclusions: ED clinicians make the diagnosis of AOM fairly accurately, although better assessment of the tympanic membrane by tympanometry and/or pneumatic otoscopy may improve accuracy. More than one-third of patients are prescribed antibiotics inappropriately. Our data can inform knowledge translation and education strategies to ensure the correct evidence-based management of this condition.

show abstract

mentioning

confidence: 99%

Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

Balasundaram

Phan

Mazzoni

et al. 2019

J Paediatrics Child Health

View full text Add to dashboard Cite

show abstract

“…40 41 Several ear health indicators that are potentially extractable from electronic health records have been recommended. 41 Though these indicators have only been validated in the primary health setting so far, there is potential for their use in the ongoing evaluation of ENT outreach programmes. Sustainable outreach benefits in disease prevention, treatment and management may occur with coordinated service delivery.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of ear, nose and throat outreach programmes for Aboriginal and Torres Strait Islander Australians: a systematic review

et al. 2020

View full text Add to dashboard Cite

ObjectiveTo examine the ability of ear, nose and throat (ENT) outreach programmes to improve health outcomes among Aboriginal and Torres Strait Islander people.MethodsWe conducted a systematic literature search of nine databases (Medline, CINAHLS, PsycINFO, Embase, Cochrane, Scopus, Global health, Informit Rural health database and Indigenous collection) and grey literature sources for primary studies evaluating ENT outreach services for Aboriginal and Torres Strait Islander people. This review included English language studies of all types, published between 2000 and 2018, that supplied ENT outreach services to Aboriginal and Torres Strait Islander Australians and provided data to evaluate their aims. Two authors independently evaluated the eligible articles and extracted relevant information. Risk of bias was assessed using the Mixed Methods Assessment Tool.ResultsOf the 506 studies identified, 15 were included in this review. These 15 studies evaluated eight different programs/activities. Studies were heterogeneous in design so a meta-analysis could not be conducted. Seven studies measured health-related outcomes in middle ear or hearing status; six reported overall positive changes one reported no clinically significant improvements. Five programmes/activities and their corresponding studies involved Aboriginal and Torres Strait Islander people and organisations in delivery and evaluation, but involvement in programme or study design was unclear.ConclusionWhile some studies demonstrated improved outcomes, the overall ability of ENT programmes to improve health outcomes for Aboriginal and Torres Strait Islander children is unclear. The impact of ENT outreach may be limited by a lack of quality evidence, service coordination and sustainability. Community codesign and supporting and resourcing local capacity must be a component of outreach programmes and ongoing evaluation is also recommended. Improvements in these areas would likely improve health outcomes.PROSPERO registration numberCRD42019134757.

show abstract

“…Aboriginal and Torres Strait Islander children suffer from the highest burden of middle ear disease in the world . More than 90% of Aboriginal and Torres Strait Islander children living in remote areas experience onset of OM by 3 months of age .…”

Section: Ent Responsementioning

confidence: 99%

“…It is time that all Australian children with hearing loss had access to appropriate hearing support . While most children with OM can be effectively managed in primary care, we need to get children who require simple ENT procedures to improve hearing on to ENT surgery waiting lists.…”

Section: Normal Hearing – Priorities For the Futurementioning

confidence: 99%

Ear, nose and throat surgery: All you need to know about the surgical approach to the management of middle‐ear effusions in Australian Indigenous and non‐Indigenous children

Kong

Lannigan

Morris

et al. 2017

J Paediatrics Child Health

View full text Add to dashboard Cite

Otitis media (OM) is a common condition in Australia. It represents a spectrum of diseases from otitis media with effusion (OME) to chronic suppurative otitis media. For all the OM diagnoses, Australian Indigenous children have higher rates of early onset, severe and persistent disease. OME is the most common form of OM and often occurs after an upper respiratory tract infection. It can be difficult to diagnose (and often goes unrecognised). Hearing loss is the most important complication. The middle-ear effusion impedes the movement of the tympanic membrane and causes a conductive hearing loss of around 25 dB. Around 20% will have a hearing loss exceeding 35 dB. Children with early onset, persistent, bilateral OME and hearing loss (or speech delay) are most likely to benefit from interventions. However, the impact of all the effective treatment options is modest. Giving advice about effective communication strategies for young children is always appropriate. The best evidence from randomised trials supports not using antihistamines and/or decongestants, considering a trial of antibiotics and referral for tympanostomy tubes. Despite the availability of evidence-based guidelines, giving advice about treatment is a challenge because recommendations vary according to condition, age, risk of complications and parental preference. While most children with OME can be effectively managed in primary care, we need to get children who meet the criteria for simple ear, nose and throat procedures that improve hearing on to ear, nose and throat surgery waiting lists. Long delays in hearing support may contribute to life-long social and economic disadvantage.

show abstract

Indicators for continuous quality improvement for otitis media in primary health care for Aboriginal and Torres Strait Islander children

Cited by 13 publications

References 10 publications

Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

Effectiveness of ear, nose and throat outreach programmes for Aboriginal and Torres Strait Islander Australians: a systematic review

Ear, nose and throat surgery: All you need to know about the surgical approach to the management of middle‐ear effusions in Australian Indigenous and non‐Indigenous children

Contact Info

Product

Resources

About