A qualitative investigation of parents' concerns, experiences and expectations in managing otitis media in children: implications for general practitioners

Abstract

Antibiotic prescribing for acute otitis media is common and studies have failed to show significant short-term benefits for their use in the treatment of this condition. Antibiotic resistance is an escalating problem related to antibiotic use and the Department of Health has published guidelines advising that they are probably unnecessary in otitis media. The aims of this study were to primarily explore parents' ideas, concerns and experiences when consulting for otitis media in children. Secondly, to develop strategies that general practitioners can use to improve doctor–patient communication and the doctors' ability to negotiate management options acceptable to patients, taking into consideration current evidence-based guidelines. A qualitative research design using focus groups were employed. The study sample interviewed were parents of children. A total of 17 parents representing a range of ages and different socio-economic backgrounds attended the focus groups. Six major themes emerged from the analysis. These themes suggested that parents' were given little information and had a poor understanding of ear infections. They expected the general practitioner (GP) to primarily make a diagnosis followed by an explanation and discussion. Parents also wished to be reassured that their child was not suffering from anything more serious, in particular, meningitis. Most were happy not to have antibiotics prescribed and preferred the doctor to make the decision about the use of antibiotics. Parents were happy to consider seeing a practice nurse when their child presented with otitis media. The strategies recommended for general practitioners is to provide a diagnosis and reassure parents about meningitis and other long-term complications and to be aware that they may overestimate parents' expectations of a prescription. General practitioners should also be flexible in involving them in the decision making process.