Otitis Media with Effusion: Our National Practice

Otitis media with effusion (OME) is the focus of an updated multidisciplinary clinical practice guideline published by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) and the American Academy of Pediatrics (AAP). Based on data from clinical trials, the guideline re...

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Bibliographic Details
Published inOtolaryngology-head and neck surgery Vol. 157; no. 2; p. 171
Main Authors Roditi, Rachel E, Rosenfeld, Richard M, Shin, Jennifer J
Format Journal Article
LanguageEnglish
Published England 01.08.2017
Subjects
Administration, Intranasal
Adult
Anti-Bacterial Agents - therapeutic use
Child
Female
Health Care Surveys
Histamine Antagonists - therapeutic use
Humans
Inappropriate Prescribing - prevention & control
Inappropriate Prescribing - statistics & numerical data
Male
Otitis Media with Effusion - drug therapy
Practice Guidelines as Topic
Practice Patterns, Physicians
Quality Improvement
Steroids - therapeutic use
United States
antibiotic
oral steroid
nasal steroid
performance metrics
otitis media with effusion
prescribing
antihistamine
child
pediatric
quality
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Summary:Otitis media with effusion (OME) is the focus of an updated multidisciplinary clinical practice guideline published by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) and the American Academy of Pediatrics (AAP). Based on data from clinical trials, the guideline recommends against using antihistamines, antibiotics, oral steroids, and intranasal steroids for OME. To understand practice patterns related to these guidelines, we assessed nationally representative data. Despite controlling for age, sex, race/ethnicity, and other potential confounders individualized for each medication class, an increased risk of antihistamine (odds ratio [OR], 3.53), antibiotic (OR, 4.31), and intranasal steroid administration (OR, 3.58) was seen when OME was diagnosed. These analyses have demonstrated opportunities for quality improvement in the care of patients with OME, quantifying gaps in practice relevant to proposed quality measures. Education targeted according to practice setting may facilitate appropriate therapy and/or referral for definitive intervention in children with OME.
ISSN:1097-6817
DOI:10.1177/0194599817703056