Randomized trial of bulb syringes for earwax: impact on health service utilization

Coppin, Richard, Wicke, Dorothy and Little, Paul (2011) Randomized trial of bulb syringes for earwax: impact on health service utilization The Annals of Family Medicine, 9, pp. 110-114. (doi:10.1370/afm.1229). (PMID:21403136).


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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.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1370/afm.1229
ISSNs: 1544-1709 (print)
Keywords: cerumen, adult, ear canal, family practice, therapeutic irrigation, medical records
Organisations: Primary Care & Population Sciences
ePrint ID: 182329
Date :
Date Event
Date Deposited: 26 Apr 2011 14:09
Last Modified: 18 Apr 2017 02:25
Further Information:Google Scholar
URI: http://eprints.soton.ac.uk/id/eprint/182329

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