Impact of Clinical Practice Guidelines on Pediatric Tonsillectomy for Tonsillitis.

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Clinical Guidelines
Authored By
Wang AJ, Cheng J
Authored On
Interests
Pediatric Medicine
ENT
Surgery
Speciality
Pediatric Medicine
Surgery
ENT
Book Detail
volume
171
ISSN
1097-6817
No. of pages
7
Publication Date
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ISSN
1097-6817 ; Electronic
IS_Ebsco
true
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Additional Info
["Wang AJ, Cheng J","Publisher: Wiley Country of Publication: England NLM ID: 8508176 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6817 (Electronic) Linking ISSN: 01945998 NLM ISO Abbreviation: Otolaryngol Head Neck Surg Subsets: MEDLINE","Journal Article","2024-12-01","Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2024 Dec; Vol. 171 (6), pp. 1949-1955. Date of Electronic Publication: 2024 Jul 21.","English","1097-6817","Tonsillectomy*\/standards , Tonsillitis*\/surgery , Guideline Adherence* , Practice Guidelines as Topic*, Humans ; Child ; Child, Preschool ; Female ; Adolescent ; Retrospective Studies ; Male ; Infant ; United States","Humans, Child, Child, Preschool, Female, Adolescent, Retrospective Studies, Male, Infant, United States, Tonsillectomy standards, Tonsillitis surgery, Guideline Adherence, Practice Guidelines as Topic","Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery","171"]
Description
Objective: To determine the impact of the release of updated American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) Clinical Practice Guidelines (CPG) for Tonsillectomy in Children in 2019 on adherence to evidence-based practice.<br />Methods: Patients between ages 1 and 18 who had tonsillectomies and encounters for throat infection (tonsillitis or pharyngitis) between of February 5, 2015 and February 4, 2023 were identified by International Classification of Diseases and Current Procedural Terminology codes, excluding those with obstructive sleep-disordered breathing. Retrospective chart review was performed to determine adherence to evidence-based practice.<br />Results: There was a significant increase in adherence to evidence-based practice post-CPG release compared to pre-CPG (85.4% vs 73.1%, P = .0088). There was an observed trend for improved adherence to evidence-based practice for pediatric tonsillectomy for recurrent infection for most of the post-CPG period. There were fewer tonsillectomies performed post-CPG, despite more total encounters for throat infection.<br />Discussion: The publication of the updated AAO-HNSF CPG corresponded with improved adherence to evidence-based practice for tonsillectomy in children for recurrent infection and an observed decrease in overall rate of tonsillectomy. This suggests the CPG may be an effective quality improvement tool for reducing variation and unnecessary patient morbidity or harm.<br />Implications for Practice: These findings suggest that the updated AAO-HNSF CPG for Tonsillectomy in Children may have effectively impacted practice patterns, and further work should be done to expand their reach to other specialties and settings. Consideration should also be given to further understand any balancing factors associated with reduced tonsillectomies for recurrent infections including quality of life impact on children managed expectantly.<br /> (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
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