Uso de seringas e bulbos em casa podem reduzir as visitas a Clinicas de Limpeza de ouvido

Randomized Trial of Bulb Syringes for Earwax: Impact on Health Service Utilization

Abstract bellow Uso domiciliar de uma seringas pode ajudar a aliviar a oclusão cera de maneira mais eficaz do que um procedimento clínico, de acordo com um estudo publicado no Annals of Family Medicine. Pesquisadores randomizaram cerca de 240 adultos no Reino Unido ou à gotas auriculares e uso doméstico de uma seringa ou a gotas para os ouvidos e irrigação por um enfermeiro da clínica. Os pacientes foram reavaliados após duas semanas, e aqueles com oclusão persistente tiveram suas orelhas irrigada na clínica. Com 2 anos de seguimento, os pacientes inicialmente tratado clinicamente retornou à clínica por preocupações acerca de cera auricular com mais freqüência do que o grupo de tratamento em casa (73% vs 60%). Os autores concluem: "Ao invés de atendimento de rotina com um clínico, auto-tratamento com gotas e depois de auto-irrigação pode oferecer uma alternativa muito menos dispendiosa".

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, 2=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

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