Shared Decision Making in Parents of Children With Acute Otitis Media

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

101 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-26

Study Completion Date

2019-06-15

Brief Summary

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This study will evaluate the efficacy of shared decision making in treatment of Acute Otitis Media in the Emergency Department setting.

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Detailed Description

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The Investigators long-term goal is to promote evidence-based, patient-centered evaluation in the acute care setting to more closely tailor antibiotic use to disease risk for Acute Otitis Media (AOM) in children.

The Investigator will conduct a single-center cluster randomized control trial comparing the efficacy, safety and patient-centered outcomes of the shared decision-making decision aid 'Acute Otitis Media Choice' to usual care among children diagnosed with acute otitis media in the ED for whom antibiotics are being considered to engage parents in shared decision-making.

Conditions

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Acute Otitis Media

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Acute Otitis Media Choice Decision Aid

For patients whose clinician is randomized to the decision aid arm:

1. The study coordinator will provide the decision aid for the parent/clinician dyad.
2. The study coordinator will provide a color-printed copy of the decision aid to the clinician prior to the clinician having the antibiotics discussion with the parents.
3. The study coordinator will offer to provide the treating clinician a concise refresher of the content included in the decision aid in the context of the trial.
4. The clinician will then, using the decision aid as a tool to facilitate discussion regarding the natural course of AOM, pain control, antibiotics exposure and deeper infections.
5. The clinician will then engage the parents in a shared decision regarding the use of immediate antibiotics versus a wait and watch prescription that is consistent with both the parent's values and preferences and the clinician's level of comfort.

Group Type OTHER

Acute Otitis Media Choice Decision Aid

Intervention Type OTHER

Decision Aid

Usual Care

the clinician will discuss management options with the parent in the clinician's usual fashion.

Group Type OTHER

Usual Care

Intervention Type OTHER

Usual Care

Interventions

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Acute Otitis Media Choice Decision Aid

Decision Aid

Intervention Type OTHER

Usual Care

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. 6 months to 18 years in age
2. Acute Otitis Media diagnosed (AOM) at the time of visit, defined as:

* Middle Ear Effusion- demonstrated by pneumatic otoscopy, air fluid level, or a bulging tympanic membrane PLUS
* Evidence of Acute Inflammation- opaque, white, yellow, or erythematous tympanic membrane or purulent effusion PLUS
* Symptoms of otalgia, fussiness or fever

Exclusion:

1. Are currently on antibiotics
2. Have acute otitis media and another diagnoses that antibiotics are prescribed for
3. Have otitis-conjunctivitis syndrome
4. Have perforation of their tympanic membrane at time of diagnoses
5. Recurrent AOM defined as:

1. ≥3 or greater separate AOM episodes in the previous 6 months or
2. ≥4 or more greater AOM episodes in the previous 12 months with one in the last 6 months
6. Have a craniofacial abnormality
7. Have had previous ear tubes placed
8. Have an immunologic disorder
9. Are immunosuppression either by disease or medication
10. Are undergoing treatment for cancer :

Minimum Eligible Age

6 Months

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No