RT Journal Article
SR Electronic
T1 Randomized Trial of Bulb Syringes for Earwax: Impact on Health Service Utilization
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 110
OP 114
DO 10.1370/afm.1229
VO 9
IS 2
A1 Coppin, Richard
A1 Wicke, Dorothy
A1 Little, Paul
YR 2011
UL http://www.annfammed.org/content/9/2/110.abstract
AB PURPOSE Bulb syringes can be used for the self-clearance of earwax and, in the short term, appear effective. We compared the long-term effectiveness of self-irrigation using a bulb syringe with routine care in United Kingdom (UK) family practice clinics where irrigating ears to remove wax is a common procedure. METHODS We assessed the impact on health service utilization as a follow-up to a single-blind, randomized, controlled trial of 237 patients attending 7 UK family practice clinics with symptomatic, occluding earwax who were randomized to an intervention group (ear drops, bulb syringe, instructions on its use and reuse) or a control group (ear drops, then clinic irrigation). After 2 years, a retrospective notes search for earwax-related consultations was carried out. We used an intention-to-treat analysis to assess differences in dichotomous outcomes between groups. RESULTS In the 2-year trial follow-up, more control group patients returned with episodes of earwax: 85 of 117 (73%) control vs 70 of 117 (60%) intervention, χ2=4.30; P = .038; risk ratio 1.21 (95% CI, 1.01–1.37). The numbers of consultations amounted to 1.15 (control) vs 0.64 (intervention) (incidence rate ratio 1.79; 95% CI, 1.05–3.04, P = .032), ie, a difference of 0.50 consultations, thus saving a consultation on average for every 2 people. CONCLUSION For patients who have not already tried bulb syringes, self-irrigation using a bulb syringe significantly reduces subsequent demand for ear irrigation by health professionals. Advocating the initial use of bulb syringes could reduce demand for ear irrigation in family practice clinics.