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Acad Emerg Med. 2019 Nov 19. doi: 10.1111/acem.13839. [Epub ahead of print]

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

Author information

1
From the, Department of Pediatrics, Division of Paediatric Emergency Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario.
2
the, Department of Pediatrics, Division of Paediatric Emergency Medicine, University of Alberta, Edmonton, Alberta.
3
Women and Children's Health Research Institute, Edmonton, Alberta.
4
the, Children's Health Research Institute, London Health Sciences Centre, London, Ontario.
5
and the, Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

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.

PMID:
31742809
DOI:
10.1111/acem.13839

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