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

2019 ◽  
Vol 26 (12) ◽  
pp. 1326-1335 ◽  
Author(s):  
Sheena Belisle ◽  
Andrei Dobrin ◽  
Sharlene Elsie ◽  
Samina Ali ◽  
Shaily Brahmbhatt ◽  
...  
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Discharge Instructions ◽  
Open Label ◽  
Randomized Controlled ◽  
Open Label Trial

scholarly journals LO89: The effectiveness of video discharge instructions for acute otitis media in children: a randomized controlled trial

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S38-S39
Author(s):  
A. Dobrin ◽  
S. Belisle ◽  
S. Ali ◽  
S. Brahmbatt ◽  
K. Kumar ◽  
...  
Keyword(s):  
Otitis Media ◽  
Controlled Trial ◽  
Acute Otitis Media ◽  
Knowledge Score ◽  
Antibiotic Use ◽  
Self Report ◽  
Knowledge Gain ◽  
Discharge Instructions ◽  
School Work ◽  
Randomized Controlled

Introduction: In children, acute otitis media (AOM) pain is undertreated. We sought to determine if video discharge instructions were associated with improved symptomatology, functional outcomes, and knowledge compared to a paper handout. Methods: We conducted a randomized controlled superiority trial comparing video discharge instructions (Easy Sketch Pro3TM) on management of pain to a paper handout detailing the same. We included caregivers of children 6 months to 5 years presenting to the emergency department (ED) with a clinical diagnosis of AOM. The primary outcome was symptomatology using the Acute Otitis Media Severity of Symptom (AOM SOS) score between 48 and 72 hours. The 7-item self-report AOM-SOS is scored from 0 to 13 with a higher score indicating more symptomatology. Secondary outcomes included knowledge gain using a 10-item survey, days of daycare/school/work missed, and recidivism. Assuming a minimal clinically important AOM-SOS difference of 2, 90% power, and 5% alpha, 60 individuals/group was needed. Results: 219 caregivers were randomized and 149 completed the 72-hour follow-up (72 paper and 77 video). The median (IQR) AOM-SOS score in the video group (adjusted for pre-intervention AOM-SOS, analgesic and antibiotic use) was significantly lower than paper [8 (7,11) versus 10 (7,13), respectively, p=0.004]. There were no significant differences between video and paper in the mean (SD) knowledge score [9.2 (1.3) versus 8.8 (1.8) correct answers, respectively, p=0.07], mean (SD) number that returned to a health provider [8/77 versus 10/72, respectively, p=0.49), mean (SD) number of daycare/schooldays missed [1.2 (1.5) versus 1.1 (2.1), respectively, p=0.62], and mean (SD) number of workdays missed by caregiver [0.5 (1) versus 0.8 (2), respectively, p=0.05]. Conclusion: Video discharge instructions are associated with less symptomatology compared to a paper handout, are effective for caregiver education in the ED, and should be used routinely.

scholarly journals THE EFFECTIVENESS OF VIDEO DISCHARGE INSTRUCTIONS FOR ACUTE OTITIS MEDIA IN CHILDREN: A RANDOMIZED CONTROLLED TRIAL

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e10-e10 ◽  
Author(s):  
Sheena Belisle ◽  
Andrei Dobrin ◽  
Sharlene Elsie ◽  
Samina Ali ◽  
Shaily Brahmbhatt ◽  
...  
Keyword(s):  
Otitis Media ◽  
Controlled Trial ◽  
Acute Otitis Media ◽  
Self Report ◽  
Knowledge Gain ◽  
Discharge Instructions ◽  
Post Intervention ◽  
School Work ◽  
Caregiver Education ◽  
Randomized Controlled

Abstract BACKGROUND Pain, the most identifiable feature of acute otitis media (AOM), is undertreated with 30% of children ≤ 2 years experiencing pain, fever, or both for up to 7 days, highlighting the importance of effective caregiver education. OBJECTIVES We sought to determine if video discharge instructions were associated with improved symptomatology, functional outcomes, and knowledge compared to a paper handout. DESIGN/METHODS We conducted a randomized controlled superiority trial comparing video discharge instructions (Easy Sketch Pro3TM) on management of pain and fever to a paper handout detailing the same. We included primary caregivers of children 6 months to 5 years presenting to the emergency department (ED) with a clinical diagnosis of AOM. The primary outcome was symptomatology using the Acute Otitis Media Severity of Symptom (AOM SOS) score between 48 and 72 hours. The 7-item self-report AOM-SOS is scored from 0 to 13 with a higher score indicating more symptomatology. Secondary outcomes included knowledge gain using a 10-item survey, days of daycare/school/work missed, and recidivism. RESULTS A total of 219 caregivers were randomized and 149 completed the 72-hour follow-up (72 paper and 77 video). Participants were primarily mothers (175/219, 79.9%); 136/219 (62.1%) completed post-secondary education and 147/219 (67.1%) had previously cared for a child with AOM. Children included 107/219 (48.6%) females with an overall mean (SD) age of 2.9 (2.8) years. Caregivers did not offer analgesia to 41/219 (18.7%) of children. The median (IQR) AOM-SOS score in the video group was significantly lower than the paper group, even after adjusting for pre-intervention AOM-SOS and medication (analgesics and antibiotics) given by caregivers [8 (7,11) versus 10 (7,13), respectively, p = 0.004]. There were no significant differences between video and paper in the mean (SD) number of correct answers given on the post-intervention survey [9.2 (1.3) versus 8.8 (1.8), respectively, p = 0.07], mean (SD) number of children that returned to a health provider [8/77 versus 10/72, respectively, p = 0.49), mean (SD) number of daycare/school missed by child [1.2 (1.5) versus 1.1 (2.1), respectively, p = 0.62, mean (SD) number of work missed by caregiver [0.5 (1) versus 0.8 (2), respectively, p = 0.05]. CONCLUSION Children of caregivers with AOM who received a five-minute video detailing the identification and management of pain and fever experienced less symptomatology compared to a paper handout. Our findings suggest that video discharge instructions in the ED are effective for caregiver education and should be used routinely.

scholarly journals Otitis media outcomes of a combined 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine and 13-valent pneumococcal conjugate vaccine schedule at 1-2-4-6 months: PREVIX_COMBO, a 3-arm randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda Jane Leach ◽  
Edward Kim Mulholland ◽  
Mathuram Santosham ◽  
Paul John Torzillo ◽  
Peter McIntyre ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Conjugate Vaccine ◽  
Otitis Media With Effusion ◽  
Controlled Trial ◽  
Acute Otitis Media ◽  
Trial Registration ◽  
Open Label ◽  
Suppurative Otitis Media ◽  
Link Type

Abstract Background Aboriginal children living in Australian remote communities are at high risk of early and persistent otitis media, hearing loss, and social disadvantage. Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the primary pathogens. We compared otitis media outcomes in infants randomised to either a combination of Synflorix™ (PHiD-CV10, with protein D of NTHi) and Prevenar13™ (PCV13, with 3, 6A, and 19A), with recommended schedules for each vaccine alone. We previously reported superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months. Methods In an open-label superiority trial, we randomised (1:1:1) Aboriginal infants at 28 to 38 days of age, to either Prevenar13™ (P) at 2–4-6 months (_PPP), Synflorix™ (S) at 2–4-6 months (_SSS), or Synflorix™ at 1–2-4 months plus Prevenar13™ at 6 months (SSSP). Ears were assessed using tympanometry at 1 and 2 months, combined with otoscopy at 4, 6, and 7 months. A worst ear diagnosis was made for each child visit according to a severity hierarchy of normal, otitis media with effusion (OME), acute otitis media without perforation (AOMwoP), AOM with perforation (AOMwiP), and chronic suppurative otitis media (CSOM). Results Between September 2011 and September 2017, 425 infants were allocated to _PPP(143), _SSS(141) or SSSP(141). Ear assessments were successful in 96% scheduled visits. At 7 months prevalence of any OM was 91, 86, and 90% in the _PPP, _SSS, and SSSP groups, respectively. There were no significant differences in prevalence of any form of otitis media between vaccine groups at any age. Combined group prevalence of any OM was 43, 57, 82, 87, and 89% at 1, 2, 4, 6, and 7 months of age, respectively. Of 388 infants with ear assessments at 4, 6 and 7 months, 277 (71.4%) had OM that met criteria for specialist referral; rAOM, pOME, or CSOM. Conclusions Despite superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months, there were no significant differences in prevalence of otitis media nor healthy ears throughout the first months of life. Trial registration ACTRN12610000544077 registered 06/07/2010 and ClinicalTrials.govNCT01174849 registered 04/08/2010.

An Open-Label, Double Tympanocentesis Study of Levofloxacin Therapy in Children With, or at High Risk for, Recurrent or Persistent Acute Otitis Media

2006 ◽  
Vol 25 (12) ◽  
pp. 1102-1109 ◽  
Author(s):  
Adriano Arguedas ◽  
Ron Dagan ◽  
Michael Pichichero ◽  
Eugene Leibovitz ◽  
Jeffery Blumer ◽  
...  
Keyword(s):  
High Risk ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Open Label

scholarly journals Antibiotics versus placebo or watchful waiting for acute otitis media: a meta-analysis of randomized controlled trials

2009 ◽  
Vol 64 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Evridiki K. Vouloumanou ◽  
Drosos E. Karageorgopoulos ◽  
Maria S. Kazantzi ◽  
Anastasios M. Kapaskelis ◽  
Matthew E. Falagas
Keyword(s):  
Randomized Controlled Trials ◽  
Otitis Media ◽  
Watchful Waiting ◽  
Meta Analysis ◽  
Acute Otitis Media ◽  
Controlled Trials ◽  
Randomized Controlled
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