Predictors of Inappropriate Use of Diagnostic Tests and Management of Bronchiolitis.

Lorena Sarmiento,Gladys E Rojas-Soto,Carlos E Rodríguez-Martínez

doi:10.1155/2017/9730696

Abstract

Background The aim of the present study was to determine predictors of inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. Methods In an analytical cross-sectional study, we determined independent predictors of the inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. We defined a composite outcome score as the main outcome variable. Results Of the 303 included patients, 216 (71.3%) experienced an inappropriate use of diagnostic tests and treatment of bronchiolitis. After controlling for potential confounders, it was found that atopic dermatitis (OR 5.30; CI 95% 1.14–24.79; p = 0.034), length of hospital stay (OR 1.48; CI 95% 1.08–2.03; p = 0.015), and the number of siblings (OR 1.92; CI 95% 1.13–3.26; p = 0.015) were independent predictors of an inappropriate use of diagnostic tests and treatment of the disease. Conclusions Inappropriate use of diagnostic tests and treatment of bronchiolitis was a highly prevalent outcome in our population of study. Participants with atopic dermatitis, a longer hospital stay, and a greater number of siblings were at increased risk for inappropriate use of diagnostic tests and management of the disease.

Highlights

Acute bronchiolitis represents the most important cause of lower respiratory tract infection during the first year of life and is the leading reason for hospitalization of infants beyond the neonatal period [1]
An implementation strategy of clinical practice guidelines (CPGs) that deal with the identified predictors could help to reduce the inappropriate use and overuse of diagnostic tests and medications that lack strong evidence that supports a recommendation for their routine use [4]
The results of this study show that there was a high prevalence of an inappropriate use of diagnostic tests and treatment of bronchiolitis in infants hospitalized in a third-level teaching referral hospital

Summary

Introduction

Acute bronchiolitis represents the most important cause of lower respiratory tract infection during the first year of life and is the leading reason for hospitalization of infants beyond the neonatal period [1]. An implementation strategy of CPGs that deal with the identified predictors could help to reduce the inappropriate use and overuse of diagnostic tests and medications that lack strong evidence that supports a recommendation for their routine use [4]. This implementation strategy could lead to the economical and effective use of health care services and the avoidance of wasting resources without reducing the quality of these services, contributing to the improvement of disease outcomes. In an analytical cross-sectional study, we determined independent predictors of the inappropriate use of diagnostic tests and management of bronchiolitis in a population of hospitalized infants. Participants with atopic dermatitis, a longer hospital stay, and a greater number of siblings were at increased risk for inappropriate use of diagnostic tests and management of the disease

Objectives

Methods

Results

Discussion

Conclusion