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Is the management of acute otitis media in children by primary care physicians in Kingston consistent with evidenced-based medicine?
Grant, C; Pierre, Russell E; Hambleton, Ian R.
Afiliação
  • Grant, C; University of the West Indies, Mona, Jamaica. Department of Obstetrics, Gynaecology and Child Health
  • Pierre, Russell E; University of the West Indies, Mona, Jamaica. Department of Obstetrics, Gynaecology and Child Health
  • Hambleton, Ian R; University of the West Indies, Mona, Jamaica. Tropical Medicine Research Unit
West Indian med. j ; 50(Suppl 5): 13-4, Nov. 2001.
Artigo em Inglês | MedCarib | ID: med-207
Biblioteca responsável: JM3.1
Localização: JM3.1; R18.W4
ABSTRACT

OBJECTIVE:

to explore the knowledge and actual management practice of acute otitis media (AOM) by primary care physicians.

METHODS:

A 19-item questionnaire was administered to all Kingston-based general practitioners and pediatricians currently listed by two major pharmaceutical companies. Data obtained included knowledge, diagnostic and therapuetic practice, and reported involvment in continuing medical education. There were 91 responders, consisting of 53 percent of the general practitioners (GPs) and 90 percent of the paediatricians listed.

RESULTS:

All the physicians except three of the GPs were participating in some aspect of continuing medical education. Fifty-two different criteria were used for the diagnosis of AOM. Only 15 of these were consistent with current best management guidelines. There was no statistically significant difference in diagnostic ability between the two groups of physicians. The four major causative agents of AOM were correctly listed by 7 percent GPs and 23 percent pediatricians (p=0.05). Amoxicillin was prescribed as first line agent for treatment of AOM by 62 percent of pediatricians and 22 percent of GPs. Trimethoprimsulfmethoxazole was still being used as first line agent by 17 percent of GPs. All physicians considered the use of analgesics as appropriate and steroids inappropriate in the management of AOM. There was significant difference between groups concerning the use of antihistamines (84 percent GPs, 53 percent paediatricians) and decongestants (91 percent GPs, 52 percent paediatricians, p<0.001) in the management of AOM. Most physicians recommeneded routine follow-up of patients at the end of the course of antibiotic treatment.

CONCLUSIONS:

Factors other than evidence-based medicine influence the current management of otitis media by primary care physicians. Exploration of the factors that determine management practice is being proposed. The results under-score the need for a re-accreditation process for physicians in the Caribbean region. (AU)
Assuntos
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Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3C Aumentar o financiamento da saúde e o recrutamento, desenvolvimento, formação e retenção da força de trabalho da saúde / Agenda de Saúde Sustentável para as Américas Problema de saúde: Autoridade e Responsabilidade dos Profissionais de Saúde / Objetivo 7: Evidência e conhecimento em matéria de saúde Base de dados: MedCarib Assunto principal: Otite Média / Médicos de Família / Medicina Baseada em Evidências / Educação Médica Continuada Tipo de estudo: Guia de prática clínica / Pesquisa qualitativa Limite: Adulto / Criança / Criança, pré-escolar / Feminino / Humanos / Masculino País/Região como assunto: Caribe Inglês / Jamaica Idioma: Inglês Revista: West Indian med. j Ano de publicação: 2001 Tipo de documento: Artigo
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Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3C Aumentar o financiamento da saúde e o recrutamento, desenvolvimento, formação e retenção da força de trabalho da saúde / Agenda de Saúde Sustentável para as Américas Problema de saúde: Autoridade e Responsabilidade dos Profissionais de Saúde / Objetivo 7: Evidência e conhecimento em matéria de saúde Base de dados: MedCarib Assunto principal: Otite Média / Médicos de Família / Medicina Baseada em Evidências / Educação Médica Continuada Tipo de estudo: Guia de prática clínica / Pesquisa qualitativa Limite: Adulto / Criança / Criança, pré-escolar / Feminino / Humanos / Masculino País/Região como assunto: Caribe Inglês / Jamaica Idioma: Inglês Revista: West Indian med. j Ano de publicação: 2001 Tipo de documento: Artigo
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