Physician specialty is associated with adherence to treatment guidelines for acute otitis media in children. (7th November 2012)

• Record Type: Journal Article
• Authors: Grossman, Zachi; Silverman, Barbara G; Miron, Dan
• Is Part Of: Acta pædiatrica. Volume 102:Number 1(2013:Jan.)
• Page Start: e29
• Page End: e33
• Publication Date: 2012-11-07
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12051
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" id="apa12051-abs-0001"> <title>Abstract</title> <sec id="apa12051-sec-0001" sec-type="section"> <title>Aim</title> <p>To identify physician and visit characteristics affecting adherence to guidelines recommending delayed antibiotic therapy for acute otitis media (AOM).</p> </sec> <sec id="apa12051-sec-0002" sec-type="section"> <title>Methods</title> <p>We used physician visit data from an Israeli health maintenance organization to identify children ages 0–15 diagnosed with AOM. We defined early antibiotic treatment as purchase, within 3 days of diagnosis, of antibiotics prescribed by the diagnosing physician. We considered the effect of physician specialty (paediatrician, otolaryngologist, and family physician), day of the week, setting (urgent care/clinic) and clinic location (peripheral/central) on the rate of early treatment.</p> </sec> <sec id="apa12051-sec-0003" sec-type="section"> <title>Results</title> <p>Proportion of cases receiving early treatment dropped from 2002 to 2009 in cases treated by otolaryngologists (47–36%) and paediatricians (46–42%) and increased in cases treated by family physicians (43–50%). Treatment rate was higher in cases treated on weekends than on weekdays (48% vs. 44%), in urgent care as compared to clinic settings (51% vs. 44%), and in children living in peripheral as compared to central areas (52% vs. 38%).</p> </sec> <sec id="apa12051-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Successful implementation of delayed treatment of otitis media guidelines requires addressing factors associated with increased early treatment rates.</p> </sec> </abstract>