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Improving patient care pathways in otitis externa.

Michael W Mather1, Hassan Mohammed1, Janet A Wilson1

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Summary
This summary is machine-generated.

Referrals for otitis externa (OE) are rising, often due to overlooked ear drops and lifestyle advice. Many patients receive inappropriate oral antibiotics instead of topical treatments, suggesting a role for community care clinics.

Keywords:
antibacterial agentsmicrobiologyotitis externaprimary health carereferral and consultation

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Area of Science:

  • Otolaryngology
  • Dermatology
  • Primary Care Medicine

Background:

  • Increasing referrals for otitis externa (OE) suggest a gap in primary care management.
  • Understanding patient journeys pre- and post-referral is crucial for optimizing care.
  • The primary-secondary care interface for OE requires further characterization.

Purpose of the Study:

  • To characterize the management of otitis externa patients before and after referral.
  • To identify areas for improvement at the primary-secondary care interface for OE.
  • To analyze referral patterns and treatment strategies for OE.

Main Methods:

  • Prospective questionnaire study at a tertiary referral center for Otolaryngology.
  • Analysis of 62 patients referred for otitis externa.
  • Data collection on primary care visits, treatments received, and risk factors.

Main Results:

  • Most OE patients (63% female, median age 57) had multiple primary care visits.
  • Oral antibiotics were common (60%), while ear drops and dry ear advice were often missed (18% and 39%).
  • Comorbidities like dermatitis and allergies were present; most ears were anatomically suitable for community care.

Conclusions:

  • Otitis externa management in primary care frequently overlooks topical treatments and lifestyle advice.
  • Inappropriate antibiotic use is common, highlighting a need for better guideline adherence.
  • Community aural care clinics could provide more timely and accessible treatment for many OE patients.