Shared Decision Making in Parents of Children With Acute Otitis Media
Acute Otitis Media
About this trial
This is an interventional treatment trial for Acute Otitis Media
Eligibility Criteria
Inclusion:
- 6 months to 18 years in age
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:
- Are currently on antibiotics
- Have acute otitis media and another diagnoses that antibiotics are prescribed for
- Have otitis-conjunctivitis syndrome
- Have perforation of their tympanic membrane at time of diagnoses
Recurrent AOM defined as:
- ≥3 or greater separate AOM episodes in the previous 6 months or
- ≥4 or more greater AOM episodes in the previous 12 months with one in the last 6 months
- Have a craniofacial abnormality
- Have had previous ear tubes placed
- Have an immunologic disorder
- Are immunosuppression either by disease or medication
- Are undergoing treatment for cancer :
Sites / Locations
- Mayo Clinic in Rochester
Arms of the Study
Arm 1
Arm 2
Other
Other
Acute Otitis Media Choice Decision Aid
Usual Care
For patients whose clinician is randomized to the decision aid arm: The study coordinator will provide the decision aid for the parent/clinician dyad. 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. 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. 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. 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.
the clinician will discuss management options with the parent in the clinician's usual fashion.