Compliance with acute otitis media treatement.

Previous studies have indicated that patient compliance with a 10-day course of antibiotics varies from 8% to 89%. Two further questions must be answered in order to support or improve patient compliance in the medial practice. First, does compliance correlate positively with an improved outcome in the disease under study; and second, if outcome is improved by compliance, what factors can be altered in the office setting to promote compliance? This study sought to determine if 1) type of medical office or population served, 2) written instructions given to the patients, or 3) patient familiarity with the prescribing physician influenced compliance with a 10-day course of antibiotics prescribed for acute otitis media. Whether compliance with this prescribed treatment was correlated with an improved outcome was subsequently determined. The study population included all patients with a new case of acute otitis media who presented to any of four different types of family practice centers involved in the study. A total of 295 patients were enrolled in the study. Results indicated that compliance, as measured by follow-up rates in less than 11 days and urine antibiotic assay results, varies significantly between different office types and patient populations. Written instruction did not improve compliance. In the low socioeconomic group, compliance was improved when the patients were diagnosed by their own physician. Neither the study factors (different office type, use of written instruction, and familiarity of the prescribing physician) nor compliance was correlated with outcome.