Video Discharge Instructions for Acute Otitis Media in Children: A Randomized Controlled Open‐label Trial

Abstract

Background Thirty percent of children with acute otitis media (AOM) experience symptoms < 7 days after initiating treatment, highlighting the importance of comprehensive discharge instructions. Methods We randomized caregivers of children 6 months to 17 years presenting to the emergency department (ED) with AOM to discharge instructions using a video on management of pain and fever to a paper handout. The primary outcome was the AOM Severity of Symptom (AOM‐SOS) score at 72 hours postdischarge. Secondary outcomes included caregiver knowledge (10‐item survey), absenteeism, recidivism, and satisfaction (5‐item Likert scale). Results A total of 219 caregivers were randomized and 149 completed the 72‐hour follow‐up (72 paper and 77 video). The median (IQR) AOM‐SOS score for the video was significantly lower than paper, even after adjusting for preintervention AOM‐SOS score and medication at home (8 [7–11] vs. 10 [7–13], respectively; p = 0.004). There were no significant differences between video and paper in mean (±SD) knowledge score (9.2 [±1.3] vs. 8.8 [±1.8], respectively; p = 0.07), mean (±SD) number of children that returned to a health care provider (8/77 vs. 10/72, respectively; p = 0.49), mean (±SD) number of daycare/school days missed by child (1.2 [±1.5] vs. 1.1 [±2.1], respectively; p = 0.62), mean (±SD) number of workdays missed by caregiver (0.5 [±1] vs. 0.8 [±2], respectively; p = 0.05), or median (IQR) satisfaction score (5 [4–5] vs. 5 [4–5], respectively; p = 0.3). Conclusions Video discharge instructions in the ED are associated with less perceived AOM symptomatology compared to a paper handout.

Video discharge instructions for pediatric gastroenteritis in an emergency department: a randomized, controlled trial

“…Alternatively, Wood [ 10 ] pointed out that the benefit of VDI depends on the disease, observing a greater improvement in caregivers’ knowledge when they received VDI for gastroenteritis than for fever/bronchiolitis. Although a single clinical trial regarding acute media otitis found no differences between paper and video instructions [ 18 ], most studies [ 3 , 10 – 12 ] agree that VDI minimize factors which affect the comprehension of the instructions such as the communication skills of healthcare providers. Our results prove that video instructions do not add extra time to the emergency department visits, as already suggested by previous articles [ 3 ] .…”

Knowledge Translation of Science Advances Into Emergency Nursing Practice With the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework

“…Whereas Wood et al 30 demonstrate the effectiveness of tailoring discharge instructions with video to improve knowledge for Spanish-speaking caregivers, other recently published evidence does not support the view that general video discharge instructions for acute otitis media, for example, increase caregiver knowledge. 31 Furthermore, in this issue of JEN, Leclerc 12 identifies the culturally contextual and relevant need for emergency nursing education in caring for indigenous patients. Finally, the adoption domain in the RE-AIM Framework includes an evaluation of who delivered the intervention.…”

Australian general practitioners’ views on qualities that make effective discharge communication: a scoping review

“…There are some examples in the international literature of using application-based and video-based methods for providing discharge communication from hospital to patients or caregivers. These include application-based discharge communication to assist stroke patients after hospital discharge (Siegel et al 2016), provision of audiovisual discharge instructions on pain and fever management to caregivers for acute otitis media in children (Belisle et al 2019) and provision of audio-visual discharge instructions to general medical inpatients on discharge (Newnham et al 2015). This scoping review did not identify any novel methods of communicating discharge information from hospitals to GPs in the Australian context.…”