Clinical practice guidelines for Indigenous peoples with middle ear disease in Australia: a systematic scoping review

Objective: This study aimed to identify practitioner awareness of and adherence to clinical practice guidelines for Indigenous peoples with otitis media in Australia. Methods: Database searches were conducted in Medline, Embase, APA PsychInfo, Scopus, Web of Science Core Collection, Academic Search Premier, and CINAHL. Studies were eligible for inclusion if they reported on practitioner awareness of or adherence to clinical practice guidelines for otitis media management for Indigenous peoples in Australia. Search terms included ‘Indigenous peoples’, ‘otitis media’, and ‘guidelines'. Results: Four peer-reviewed studies published between 2007 and 2020 met eligibility for inclusion. This review identified three key concepts: (1) practitioner awareness rates for the Therapeutic Guidelines were significantly higher than for the 2001 OM Guidelines, (2) practitioners self-reported higher adherence to the Therapeutic Guidelines compared with the 2001 OM Guidelines, and (3) antibiotic prescriptions for Indigenous children varied, possibly due to use of different guidelines and adherence criteria, as well as variations in geographical areas and settings. Conclusions: Practitioner adherence to clinical practice guidelines specific for Indigenous peoples with otitis media is critical to ensuring a consistent impact and, by extension, closing the gap in related life outcomes for Indigenous peoples in Australia. It is important to evaluate guideline impact through establishing current practitioner adherence rates. Furthermore, increasing awareness of culturally appropriate research approaches and availability of evaluation tools, such as the Aboriginal and Torres Strait Islander Quality Appraisal Tool, should improve the conduct of future Indigenous research.