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No3(4) 2021

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DOI 10.37219/2528-8253-2021-3-71
Semenyuk O.O., Moksalyk O.Ye.
Ways to increase compliance in patients with acute otitis externa
Semenyuk Oleksandr O.
Danylo Halytskyi Lviv National Medical University
Department of Otorhinolaryngology
Assistant professor
PhD, MD
E-mail: oles.semenyuk@gmail.com
ORCID ID: 0000-0003-3420-6640
Researcher ID: C-5014-2019
Scopus Author ID: 57205056755

Moskalyk Oksana Ye.
Danylo Halytskyi Lviv National Medical University
Department of Otorhinolaryngology
Head of Department, Associate professor
PhD, MD

Abstract

Topicality: The problem of diagnosis and treatment of otitis externa (OE) has been posed to doctors for a long time, and until the discovery of antibiotics (AB) and antifungal drugs (AFD) remained unresolved. OE can affect up to 10% of people at different periods of their lives, manifesting itself in the form of acute OE (AOE) in 95% of cases after the age of 2 years. There is a reduction in the number of patients admittance to the ENT specialist with the onset of the COVID-19 pandemic while maintaining the structure of the pathology, where AOE - in the top three of frequency. At the same time, there are a reports of an increasing amount of AOE cases in patients with COVID-19.
Aim: To evaluate the dynamics of pain, the need for additional analgesia, systemic antibacterial therapy (ABT) or topical antifungal therapy (TAT), the level of compliance in patients with AOE in empirical treatment with a complex drug «Candibiotic» in comparison with protocol treatment.
Material and methods: The study included adults and children from 2 years of age with a diagnosis of AOE: 30 patients in the main (17 adults, 13 children) and 25 patients in the control (15 adults, 10 children) groups. Patients in the main group as a basic treatment received topical ear drops «Candibiotic». Patients in the control group received protocol treatment. If necessary, patients were additionally prescribed analgesic therapy (ibuprofen in the appropriate dose), systemic ABT or TAT. For subjective pain asses, a visual analog scale (VAS) was used. Compliance was assessed using the Morisky-Green questionnaire. The obtained results were processed by common statistical methods.
Results and discussion: In the main group of patients receiving «Candibiotic», there were fewer needs for additional systemic analgesia, systemic ABT, no one needed additional TAT. Comparison of the obtained results (percentage) in the form of arbitrary tables using the chi-squared test established that the relationship between factor and performance traits is not statistically significant (p>0.05). The mean compliance score between the two study groups differed significantly as a whole and separately between the groups of adults and children (p<0.05).
Conclusion: In patients of adult and pediatric age with a diagnosis of AOE at the initial empirical appointment of the drug «Candibiotic» there was less need for additional analgesia, the appointment of systemic ABT and AFT. Such results did not differ statistically significantly from the results in adult and pediatric patients who were prescribed protocol treatment of AOE. Patients with «Candibiotic» monotherapy had a significantly higher average compliance score compared with the control group, especially among parents of children with AOE. The complex composition of ear drops «Candibiotic» contributes to a high adherence to treatment in patients, and the lack of an absolute analogue makes it the means of choice for the initial empirical treatment of AOE in adults and children over 2 years.

Keywords

acute otitis externa, compliance, adults, children.


Reference

  1. Barry V, Bhamra N, Balai E, Maung S. Otitis externa. BMJ. 2021 Mar 31;372:n714. doi: 10.1136/bmj.n714. PMID: 33789841.
  2. Betito HR, Dahan T, Halperin D, Katzenell U. [Implantation of a vibrant soundbridge in a woman with sensorineural hearing loss and recurrent otitis externa: a case study]. Harefuah. 2021;160(3):155-160. [Article in Hebrew].
  3. Carter S, Taylor D, Levenson R. 3. London: Medicines Partnership; 2005. A question of choice – compliance in medicine taking. From compliance to concordance. Journal of Food Security. 2019; 7(3):97-102. DOI: 10.12691/jfs-7-3-5.
  4. De Greve G, van Dinther J, Vanspauwen R, Youri M, Verstreken M, Zarowski A, Offeciers E. The MO-meatocanalplasty: long-term results in the narrow external auditory canal with recurrent otitis externa or the inability to wear a hearing aid. Eur Arch Otorhinolaryngol. 2021 Feb 20. doi: 10.1007/s00405-020-06599-z.
  5. Glantz SA. Primer of Biostatistics. 7th ed. McGraw-Hill Education/Medical; 2012. 320 p.
  6. Hajioff D, MacKeith S. Otitis externa. BMJ Clin Evid. 2015 Jun 15;2015:0510.
  7. Harrison E, Cronin M. Otalgia. Aust Fam Physician. 2016 Jul;45(7):493-7.
  8. Herranz-Larraсeta J, Klein-Rodrнguez A, Menйndez-Riera M, Mejuto-Torreiro L, Lуpez-Eiroa A, Vбzquez-Barro JC, Herranz Gonzбlez-Botas J, Mayo-Yбсez M. ENT emergencies during the first wave of COVID-19 pandemic in Spain: Our experience. Am J Otolaryngol. 2021 Mar-Apr;42(2):102865. doi: 10.1016/j.amjoto.2020.102865.
  9. Mady OM, El-Ozairy HS, Wady EM. Increased incidence of otitis externa in covid-19 patients. Am J Otolaryngol. 2020 Aug 11:102672. doi: 10.1016/j.amjoto.2020.102672.
  10. Medina-Blasini Y, Sharman T. Otitis Externa. In: StatPearls [Internet]. Treasure Island (FL): Stat-Pearls Publishing; 2021 Jan.2020 Oct 1. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK556055.
  11. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986; 24(1): 67-74. doi: 10.1097/00005650-198601000-00007.
  12. Neilan RE, Roland PS. Otalgia. Med Clin North Am. 2010;94(5):961-71. doi: 10.1016/j.mcna.2010.05.004.
  13. Ni G, Curtis S, Kaplon A, Gildener-Leapman N, Brodsky J, Aaron K, Mouzakes J. Development of video otoscopy quiz using a smartphone adaptable otoscope. J Otol. 2021;16(2):80-84. doi: 10.1016/j.joto.2020.08.001.
  14. Ojetti V, Covino M, Brigida M, Petruzziello C, Saviano A, Migneco A, Candelli M, Franceschi F. Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone? Medicina (Kaunas). 2020;56(10):512.
    doi: 10.3390/medicina56100512.
  15. Pabis E. [Evaluation of postoperative pain in children]. Nursing Topics. 2011;19(1):122-9. DOI: 10.5603. [Article In Poland]
  16. Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA, Huang WW, Haskell HW, Robertson PJ. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. 2014 Feb;150(1 Suppl):S1-S24.
    doi: 10.1177/ 0194599813517083.
  17. Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA, Huang WW, Haskell HW, Robertson PJ; American Academy of Otolaryngology--Head and Neck Surgery Foundation. Clinical practice guideline: acute otitis externa executive summary. Otolaryngol Head Neck Surg. 2014;150(2):161-8. doi: 10.1177/0194599813517659.
  18. Stansfield J, Dobbs S, Harrison R, Lee K, Sharma S, Okour K, Agrawal S, Miah MS. Management of ENT emergencies during the coronavirus disease 2019 pandemic. J Laryngol Otol. 2021;135(2):117-24. doi: 10.1017/S0022215121000530.
  19. Starck М, Atula S. Настанова 00852. Зовнішній отит. Duodecim. [online] 2018. URL: https://guidelines.moz.gov.ua/documents/3627.
  20. Stubington TJ, Morrison B, Sevilla C, Judd O. What still presents urgently to ENT during a pandemic? Experience of an ENT rapid access clinic during the coronavirus disease 2019 pandemic. J Laryngol Otol. 2021;135(1):70-3.
    doi: 10.1017/ S0022215121000128.
  21. Tomlinson D, von Baeyer CL, Stinson J, Sung, L. A systematic review of faces scales for the selfreport of pain intensity in children. Pediatrics. 2010;126(5):e1168-98. doi: 10.1542/peds.2010-1609.
  22. Torrance R. Rare Case of Otitis Externa Parasitica. Br Med J. 1880 Oct 9;2(1032):582. doi: 10.1136/bmj.2.1032.582.
  23. Trinidade A, Qayyum A, Lee A, Shakeel M, Osbourne S, Kotecha B. Audit of otitis externa referrals and management in a tertiary care setting. J Otolaryngol Head Neck Surg. 2011; 40(4):288-94.
  24. World Health Organization. Adherence to long term therapies: evidence for action [online] 2003.
    URL: http://www.who.int/chronic_conditions/en/adheren ce_report.pdf.
  25. Zwartenkot JW, Hashemi J, Cremers CW, Mulder JJ, Snik AF. Active middle ear implantation for patients with sensorineural hearing loss and external otitis: long-term outcome in patient satisfaction. Otol Neurotol. 2013;34(5):855-61. doi: 10.1097/MAO.0b013e31828f47c2.
 

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