scholarly journals National Quality Evaluation of Medication Use for Pediatric Otitis Media With Effusion

2021 ◽  
pp. 014556132110205
Author(s):  
Yu-Lu Chen ◽  
Te-Yung Fang ◽  
Pa-Chun Wang ◽  
Ya-Hui Chen ◽  
Ting-Chuan Wang ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Drug Use ◽  
Otitis Media ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Otitis Media With Effusion ◽  
Medication Use ◽  
Intranasal Steroids ◽  
Antibiotics Use ◽  
Systemic Antibiotics

Objectives: Otitis media with effusion (OME) is characterized by the presence of fluid in the middle ear without the presentation of signs or symptoms of acute ear infection. The point prevalence of OME reaches as high as 60% in children younger than 2 years of age. We used the National Health Insurance Research Database (NHIRD) to investigate the use of medication in children with OME before receiving ventilation tube insertion (VTI). Methods: Data of pediatric patients (age ≤ 12 years) who had OME and received VTI from January 1, 2011, to December 30, 2012, were retrieved from the Taiwan NHIRD. We surveyed the use of 4 medications to understand whether health care providers achieved the standards of medication use recommended by clinical practice guidelines. Results: This study examines the factors affecting the use of medication for pediatric OME. Overall, according to the study’s operational definitions, the use of systemic antibiotics was most common (59.9%), followed by systemic antihistamines (23.4%), systemic steroids (8.8%), and intranasal steroids (9.6%). Systemic antibiotics use was associated with 12 factors. Ten of the 12 factors increase the use of systemic antibiotics, including namely age (age > 2 years), comorbidities, teaching hospital, and community hospital. In contrast, namely catastrophic illness and watchful waiting are the 2 factors that decrease systemic antibiotics use. For the use of systemic antihistamines, systemic steroids, and intranasal steroids were related to 6, 5, and 2 factors, respectively. Conclusions: The rate of drug use differs from the rate of use recommended by commonly used clinical practice guidelines. We found that the higher the number of factors that influenced the patients’ drug use, the higher the rate of drug use. According to these results, drafting a treatment guideline for OME patients in accordance with current clinical practices in Taiwan is highly recommended.

Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan, 2015

2017 ◽  
Vol 44 (5) ◽  
pp. 501-508 ◽  
Author(s):  
Makoto Ito ◽  
Haruo Takahashi ◽  
Yukiko Iino ◽  
Hiromi Kojima ◽  
Sho Hashimoto ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Otitis Media ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Otitis Media With Effusion ◽  
Diagnosis And Management

Adherence to American Academy of Otolaryngology–Head and Neck Surgery Clinical Practice Guidelines: A Systematic Review

2020 ◽  
Vol 163 (4) ◽  
pp. 626-644
Author(s):  
Marisa A. Ryan ◽  
Grace R. Leu ◽  
Emily F. Boss ◽  
Eileen M. Raynor ◽  
Jonathan M. Walsh
Keyword(s):  
Clinical Practice ◽  
American Academy ◽  
Head And Neck ◽  
Otitis Media ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Otitis Media With Effusion ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Publication Date

Objective Clinical practice guidelines synthesize and disseminate the best available evidence to guide clinical decisions and increase high-quality care. Since 2004, the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) has published 16 guidelines. The objective of this review was to evaluate clinicians’ adherence to these guidelines’ recommendations as measured in the literature. Data Sources We searched PubMed, Embase, and Web of Science on August 29, 2019, for studies published after June 1, 2004. Review Methods We systematically identified peer-reviewed studies in English that reported clinician adherence to AAO-HNSF guideline recommendations. Two authors independently reviewed and abstracted study characteristics, including publication date, population, sample size, guideline adherence, and risk of bias. Results The search yielded 385 studies. We excluded 331 studies during title/abstract screening and 32 more after full-text review. The remaining 22 studies evaluated recommendations from 8 of the 16 guidelines. The Otitis Media with Effusion, Polysomnography, Tonsillectomy, and Sinusitis guidelines were studied most. Study designs included retrospective chart reviews (7, 32%), clinician surveys (7, 32%), and health care database analyses (8, 36%). Studies reported adherence ranging from 0% to 99.8% with a mean of 56%. Adherence varied depending on the recommendation evaluated, type of recommendation, clinician type, and clinical setting. Adherence to the polysomnography recommendations was low (8%-65.3%). Adherence was higher for the otitis media with effusion (76%-90%) and tonsillectomy (43%-98.9%) recommendations. Conclusions Adherence to recommendations in the AAO-HNSF guidelines varies widely. These findings highlight areas for further guideline dissemination, research about guideline adoption, and quality improvement.

scholarly journals Applicability of somatic monitoring instructions in clinical practice guidelines on antipsychotic drug use

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jurriaan M. J. L. Brouwer ◽  
Erien Olde Hengel ◽  
Arne J. Risselada ◽  
Eric N. van Roon ◽  
Hans Mulder
Keyword(s):  
Clinical Practice ◽  
Drug Use ◽  
Adverse Effects ◽  
Antipsychotic Drug ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Frail Elderly ◽  
Antipsychotic Drugs ◽  
Electronic Database ◽  
Elderly Populations

Abstract Background Clinical practice guidelines (CPGs) recommend the monitoring of somatic parameters in patients treated with antipsychotic drugs in order to detect adverse effects. The objective of this study was to assess, in adult and (frail) elderly populations, the consistency and applicability of the somatic monitoring instructions recommended by established CPGs prior to and during antipsychotic drug use. Methods A search for national and international CPGs was performed by querying the electronic database PubMed and Google. Somatic monitoring instructions were assessed for adult and (frail) elderly populations separately. The applicability of somatic monitoring instructions was assessed using the Systematic Information for Monitoring (SIM) score. Somatic monitoring instructions were considered applicable when a minimum SIM score of 3 was reached. Results In total, 16 CPGs were included, with a total of 231 somatic monitoring instructions (mean: 14; range: 0–47). Of the somatic monitoring instructions, 87% were considered applicable, although critical values and how to respond to aberrant values were only present in 28 and 52% of the available instructions respectively. Only 1 CPG presented an instruction specifically for (frail) elderly populations. Conclusions We emphasize the need for a guideline with somatic monitoring instructions based on the SIM definition for both adult and (frail) elderly populations using antipsychotic drugs. In addition, CPGs should state that clear agreements should be made regarding who is responsible for interventions and somatic monitoring prior to and during antipsychotic drug use.

Pediatric Clinical Practice Guidelines & Policies

2014 ◽  
Author(s):  
Keyword(s):  
Clinical Practice ◽  
Otitis Media ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Full Text ◽  
Acute Otitis Media ◽  
Policy Statement ◽  
Clinical Report ◽  
Cd Rom ◽  
Diagnosis And Management

New! Keep up with current practice guidelines and policies with the latest, most up-to-date edition of this clinical reference classic. This evidence-based decision-making tool for managing common pediatric conditions has been revised and updated for 2014, with the latest clinical practice guidelines for more than 30 conditions, plus every AAP policy statement, clinical report, and technical report through December 2013. Updated and expanded for 2014 including: - Three new AAP clinical practice guidelines - Management of Newly Diagnosed Type 2 Diabetes Mellitus - Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years - Diagnosis and Management of Acute Otitis Media - New Periodicity Schedule - Full text of more than 60 new or revised AAP policies - CD-ROM includes the full text of more than 400 AAP clinical practice guidelines, policy statements, clinical reports, and technical reports. - More than 30 clinical practice guidelines including Sleep Apnea, ADHD, bronchiolitis, dysplasia of the hip, gastroenteritis, otitis media, urinary tract infection and more. - 2014 immunization schedule.

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