{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:14:17Z","timestamp":1780092857056,"version":"3.54.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Referrals for otitis externa (OE) have dramatically increased but the reasons for this remain unclear. We aim to characterize management of patients both pre- and post-referral to identify areas of improvement at the primary\u2013secondary care interface.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Questionnaire study from consultant-led research clinic specifically set up to prospectively analyse OE referrals at a tertiary referral centre for Otolaryngology.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sixty-two patients were included; 63% female, median age 57 years. One was excluded (clinically not OE). Most patients had multiple primary care visits before referral (average 4 GP; 2 practice nurse). Sixty per cent had received oral antibiotics (16% multiple classes). Eighteen per cent had never had ear drops. Thirty-nine per cent were not advised to keep ears dry. Twenty-one per cent had dermatitis; 13% contact allergy, 30% systemic allergy, 5% diabetes. Less than 10% had narrow canals. Thirty-six per cent had active discharge but &amp;lt;7% needed a wick. Approximately 75% appear suitable for community aural care clinics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>OE occurs most commonly in female patients, often with associated risk factors. Patients often consult primary care several times prior to referral. Lifestyle advice and ototopical drops are frequently overlooked; instead, often inappropriately treated with oral antibiotics. Most ears were anatomically normal, and community aural care clinics may have a role in more timely and accessible treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmab181","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T12:15:52Z","timestamp":1640088952000},"page":"971-973","source":"Crossref","is-referenced-by-count":2,"title":["Improving patient care pathways in otitis externa"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7972-7111","authenticated-orcid":false,"given":"Michael W","family":"Mather","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Freeman Hospital , High Heaton, Newcastle-upon-Tyne NE7 7DN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Freeman Hospital , High Heaton, Newcastle-upon-Tyne NE7 7DN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet A","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Freeman Hospital , High Heaton, Newcastle-upon-Tyne NE7 7DN , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"issue":"468","key":"2022092414282522800_CIT0001","first-page":"533","article-title":"Otitis externa in UK general practice: a survey using the UK General Practice Research Database.","volume":"51","author":"Rowlands","year":"2001","journal-title":"Br J Gen Pract"},{"key":"2022092414282522800_CIT0002","author":"NHS-Digital.","year":"2019"},{"key":"2022092414282522800_CIT0003","author":"NICE.","year":"2021"},{"issue":"4","key":"2022092414282522800_CIT0004","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"6","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"issue":"1","key":"2022092414282522800_CIT0005","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1136\/thx.2004.038844","article-title":"Time trends in allergic disorders in the UK.","volume":"62","author":"Gupta","year":"2007","journal-title":"Thorax"},{"issue":"8","key":"2022092414282522800_CIT0006","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1080\/09546634.2019.1655137","article-title":"Atopic dermatitis epidemiology and unmet need in the United Kingdom.","volume":"31","author":"Cork","year":"2020","journal-title":"J Dermatolog Treat"},{"key":"2022092414282522800_CIT0007","year":"2018"},{"issue":"3","key":"2022092414282522800_CIT0008","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s00405-011-1687-7","article-title":"The management of otitis externa in UK general practice.","volume":"269","author":"Pabla","year":"2012","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2022092414282522800_CIT0009","author":"World Health Organisation.","year":"2016"},{"issue":"2","key":"2022092414282522800_CIT0010","doi-asserted-by":"crossref","first-page":"102894","DOI":"10.1016\/j.amjoto.2020.102894","article-title":"Malignant otitis externa: an updated review.","volume":"42","author":"Trevi\u00f1o Gonz\u00e1lez","year":"2021","journal-title":"Am J Otolaryngol"},{"key":"2022092414282522800_CIT0011","author":"NICE.","year":"2018"},{"issue":"11","key":"2022092414282522800_CIT0012","doi-asserted-by":"crossref","first-page":"3371","DOI":"10.1093\/jac\/dkz345","article-title":"Antibiotic choice in UK general practice: rates and drivers of potentially inappropriate antibiotic prescribing.","volume":"74","author":"Nowakowska","year":"2019","journal-title":"J Antimicrob Chemother"},{"key":"2022092414282522800_CIT0013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0022215121003005","article-title":"Otitis externa - what is the problem with getting it right? A mixed-methods study in primary and secondary care.","author":"Mohammed","year":"2021","journal-title":"J Laryngol Otol"},{"issue":"4","key":"2022092414282522800_CIT0014","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1046\/j.1365-2273.2003.00715.x","article-title":"Comparison of compliance between topical aural medications.","volume":"28","author":"Lancaster","year":"2003","journal-title":"Clin Otolaryngol Allied Sci"},{"issue":"10","key":"2022092414282522800_CIT0015","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1017\/S0022215100131780","article-title":"Is a community-based mastoid microsuction service feasible: the audit of a pilot project.","volume":"109","author":"Lewis","year":"1995","journal-title":"J Laryngol Otol"}],"container-title":["Family Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/fampra\/article-pdf\/39\/5\/971\/45991148\/cmab181.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/fampra\/article-pdf\/39\/5\/971\/45991148\/cmab181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T14:29:43Z","timestamp":1664029783000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/fampra\/article\/39\/5\/971\/6505226"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,12]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,1,12]]},"published-print":{"date-parts":[[2022,9,24]]}},"URL":"https:\/\/doi.org\/10.1093\/fampra\/cmab181","relation":{},"ISSN":["1460-2229"],"issn-type":[{"value":"1460-2229","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,10,1]]},"published":{"date-parts":[[2022,1,12]]}}}