As the predominant symptom of an acute middle ear infection (acute otitis media; AOM), ear pain is central to families’ experience of the illness. Most clinical guidelines on AOM for doctors, therefore, include recommendations on the use of pain medication. Usually, these include the use of paracetamol and, in case of insufficient pain relief, either switch to ibuprofen, or give ibuprofen on top of paracetamol. In a busy clinic, however, doctors may fail to give parents detailed advice on how best to manage ear pain; as a result children might suffer unnecessarily. This could lead to parents consulting their doctor more often, and requesting antibiotics even though AOM can often be treated without them.
Thus far, there has been little research that aims to improve pain management in AOM. We, therefore, developed a training aimed at educating general practitioners (GPs) about pain management in children with AOM. This training included an online training module and a face-to-face visit by the study physician. GPs were trained to discuss pain management with parents in detail using an information leaflet and to give a prescription for pain medication rather than suggest to parents to buy it over the counter. The training emphasised the importance of regular and weight-appropriate dosing of paracetamol and suggested to prescribe ibuprofen in addition to paracetamol when needed.