Influences of Antibiotic Medication Compliance for the Treatment of Acute Otitis Media in Children

Wendy A. Hughes

OBJECTIVE: To determine the relationship of antibiotic medication compliance and factors affecting parental rationale for medication compliance. To describe and compare the relationships: a) between antibiotic compliance and perceived benefit, relationship with clinician, family belief in medication, perception of illness, financial obstacles, and adverse reactions; b) between medication compliance for groups receiving written instructions and verbal instructions for the home treatment of acute otitis media; and between self-reported compliance and medication measurement after completion of antibiotic therapy. DESIGN: Exploratory descriptive with a structured interview. SETTING: Spokane Regional Health District Pediatric Clinics in Spokane, Washington, October through December of 1996. PARTICIPANTS: Parents of 10 children (9 males and 1 female) between the ages of birth and 12 years of age, diagnosed and treated with antibiotic therapy for acute otitis media. Parents were alternately assigned to a group receiving written and verbal education, or only verbal education. MAIN OUTCOME MEASURES: All patients received verbal information regarding the diagnosis and treatment of acute otitis media and demonstration of a calibrated medicine spoon to be used for medication administration. In addition, one part of the group (n=4) received written educational materials to reinforce verbal education. Medication compliance was measured by parental report on the medication administration record and measurement of remaining antibiotic suspension. Parents were then interviewed at the 10-14 day follow-up appointment using the structured interview format of a Modified Ratings of Medication Influences Scale. RESULTS: Although this study attempted to show a relationship between parental rationale for medication compliance behaviors and written educational materials, the results did not support a significant difference between the group receiving only verbal education and the group which received verbal and written education. Parental report of perception of the child's illness as a strong factor affecting compliance was present in 90% of the parental report in the semi-structured portion of the Modified Ratings of Medication Influences interview. Pearsons product moment correlation coefficient of 0.9141 (p=O.OOO) indicates significant relationship between parental report of medication compliance and practitioner measurement of residual antibiotic solution. CONCLUSIONS: A larger sample is required to determine relationship between medication compliance and influences of individual behavioral factors in the Modified Ratings of Medication Influences Scale. In this pilot study, parental report of medication compliance was not statistically different than residual measurement for the assessment of the degree of medication compliance, indicating similar accuracy for the assessment of medication compliance.

Influences of Antibiotic Medication Compliance for the Treatment of Acute Otitis Media in Children

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