Interventions to De-implement Unnecessary Antibiotic Prescribing for Children With Ear Infections

Launched by DENVER HEALTH AND HOSPITAL AUTHORITY · Sep 5, 2023

Keywords

ClinConnect Summary

This clinical trial is investigating ways to reduce unnecessary antibiotic prescriptions for children with ear infections, known as Acute Otitis Media. The goal is to improve healthcare for these children by comparing two methods: a standard approach that includes educating doctors and providing tools to track their prescribing habits, and a new method that adds a focus on shared decision-making. This means parents can be more involved in discussions about their child's treatment, which may lead to greater satisfaction with care and potentially less use of antibiotics.

To participate, children must be between 6 months and 17 years old and have been diagnosed with an ear infection by a healthcare provider. Parents or guardians over 18 years old will also be involved. Participants can expect to complete surveys and possibly take part in focus groups or interviews to share their experiences. The study aims to gather feedback to help improve how care is delivered and to ensure that both parents and healthcare providers are happy with the treatment options available.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • A. Implementation of Interventions 1. Clinic at a participating organization 2. Provides care to children with AOM 3. Administrative or local approval for participation
• • B. Secondary Electronic Health Record Data
• • 1. Aged 6 months-17-years-old (inclusive)
• • 2. Diagnosis of AOM by ICD10 code
• • C. Video recordings or direct observation of the use of a shared decision aid
• Parent participation:
• • 1. Child aged 6 months-17 years (inclusive)
• • 2. Diagnosed with AOM by clinician
• • 3. Parent or legal guardian is present and is \>=18 years or older
• Clinician Participation:
• • 1. Licensed clinician and not a medical trainee
• • 2. Age 18 \>= years or older
• • D. Pre-implementation interviews of clinicians and administrators
• • 1. Licensed clinician (physician or advanced practice clinician) that cares for children with AOM at a participating organization or an administrator/manager at a participating organization.
• • 2. Aged \>=18 years-no maximum
• • E. Pre-implementation focus groups of parents
• • 1. Parent or legal guardian of a child aged 6 months-17 years (inclusive) that has had AOM diagnosed at a participating organization.
• • 2. 18 years of age or older and able/willing to consent
• • F. Parents enrolled for surveys
• • 1. Parent or legal guardian of a child aged 6 months-17 years (inclusive) that has had AOM diagnosed at a participating organization. 2. Willing to participate and able to complete electronic surveys at enrollment and 10 days after enrollment. 3. Working phone 4. Age \>=18 years of age
• • G. Post-intervention focus groups of parents
• • 1. Parent or legal guardian of a child aged 6 months-17 years (inclusive) that has had AOM diagnosed at a participating organization.
• • 2. 18 years of age or older and able/willing to consent
• • H. Post-intervention surveys of clinicians and administrators
• • 1. Licensed clinician (physician or advanced practice clinician) that cares for children with AOM at a participating organization or an administrator/manager at a participating organization.
• • 2. Aged \>=18 years-no maximum
• Exclusion Criteria:
• • A. Implementation of Interventions
• • 1. Clinics that exclusively provide telehealth
• • B. Secondary Electronic Health Record Data
• • 1. None
• • C. Video recordings or direct observation of the use of a shared decision aid
• Parent participation:
• • 1. None
• Clinician Participation:
• • 1. None
• • D. Pre-implementation interviews of clinicians and administrators 1. Medical trainee (student, resident, fellow, etc.)
• • E. Pre-implementation focus groups of parents
• • 1. None
• • F. Parents enrolled for surveys 1. Complicated or recurrent AOM as determined by the study team
• • G. Post-intervention focus groups of parents 1. None
• • H. Post-intervention surveys of clinicians and administrators
• • 1. Medical trainee (student, resident, fellow, etc.)