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Harris R, Lowers V, Hulme C, Burnside G, Best A, Clarkson JE, Cooke R, Van Der Zande M, Maitland R. Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial. Trials 2022; 23:475. [PMID: 35672830 PMCID: PMC9172193 DOI: 10.1186/s13063-022-06418-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with disadvantaged backgrounds are less likely to visit the dentist for planned care, even though they have disproportionately poorer oral health. They are correspondingly more likely to experience dental problems and use urgent dental care, general practices and Accident and Emergency departments, which not only makes meeting their needs expensive, but, since these services often rely on prescriptions rather than addressing the clinical cause, can contribute to antimicrobial resistance. METHODS The RETURN intervention has been developed with substantial community co-production, to be delivered opportunistically in urgent dental care settings. This brief intervention is delivered by dental nurses and involves material relevant to the 'in-group' targeted. The material includes booklets relating to barriers to planned dental visiting with corresponding short video clips featuring local people and including a modelling element. Dental nurses are trained to have supportive and non-judgemental conversations, assisting patients to set personal goals and action plans, which are reinforced in a follow-up text within a few weeks. A randomised controlled trial will be undertaken in 3 types of sites: dental practices delivering urgent care (a) within working hours, (b) out of hours, and (c) in a Dental Hospital. The trial will recruit 1180 adult urgent dental care users over 12 months, who have not visited a dentist for a planned care appointment for 2 years or more and do not have a dentist who they visit for routine care. It aims to investigate the effectiveness and cost-effectiveness of the intervention and to explore whether the intervention has different effects across the socio-economic gradient. Participants will be followed up at 6, 12 and 18 months after randomisation. Co-primary outcomes are attendance at a dental practice for planned care within 12 months and self-reported oral health-related quality of life at 12 months. DISCUSSION This is a pragmatic trial, evaluating the effectiveness of the intervention under the usual condition in which it might be applied. Since dental practices work as independent contractors to the NHS, this brings implementation and fidelity challenges which will be explored and described in embedded qualitative work. TRIAL REGISTRATION ISRCTN registry identifier ISRCTN84666712. Registered 12/04/2021.
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Affiliation(s)
- R Harris
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Whelan Building, Liverpool, L69 3GL, UK.
| | - V Lowers
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - C Hulme
- Health Economics Group, Institute of Health Research University of Exeter Medical School, Exeter, UK
| | - G Burnside
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - A Best
- Liverpool Clinical Trials Centre, Clinical Directorate, University of Liverpool, Liverpool, UK
| | - J E Clarkson
- Division of Oral Health Sciences, Dental Hospital & School, Park Place, Dundee, UK
| | - R Cooke
- School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent, ST4 2DE, UK
| | - M Van Der Zande
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - R Maitland
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK.,Liverpool Clinical Trials Centre, Clinical Directorate, University of Liverpool, Liverpool, UK
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Effectiveness of and Patient’s Satisfaction with Dental Emergency Unit in Pitié Salpêtrière Hospital (Paris), Focusing on Pain and Anxiety. Int J Dent 2022; 2022:8457608. [PMID: 35637654 PMCID: PMC9148244 DOI: 10.1155/2022/8457608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/02/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Dental Emergency Unit (DEU) of the Pitié Salpêtrière Hospital receives mainly painful emergencies. This study aimed at evaluating the suppression of pain and anxiety as well as the patient's satisfaction after a visit to the DEU. Patients and Methods. A prospective study was carried out in 2019 (NCT03819036) in adult patients. Data was collected on D0 on site and then on D1, D3, and D7 by phone, during daytime. The main objective and secondary objectives were, respectively, to assess the intensity of pain on D1; the intensity of pain on D3 and D7; the evolution of anxiety on D1, D3, and D7; and the patients' satisfaction. They were evaluated with a 0–10 numeric scale (NS) on D1, D3 and D7; mean scores were compared with nonparametric statistics (ANOVA, Dunn's test). Results 814 patients were contacted and 581 patients included; 87 were lost to follow-up. 376 patients completed all the questionnaires. In the final sample (59% men, 40 ± 16 y.o.), 86% had health insurance. The mean pain scores were as follows: D0: 6.36 ± 0.12; D1: 3.49 ± 0.13; D3: 2.23 ± 0.13; D7: 1.07 ± 0.11—indicating a significant decrease of 45%, 65%, and 93% on D1, D3, and D7, respectively, compared to D0 (p < 0.0001) between D0 and D1, D3, D7. The mean NS anxiety scores were as follows: D0: 3.32 ± 0.15; D1: 3.69 ± 0.16; D3: 2.75 ± 0.16; D7: 1.98 ± 0.15. The decrease was significant between D0 and D7 (p < 0.0001). The perception of general heath improved between D1 and D7. The overall score of satisfaction was 8.64 ± 0.06. Conclusion DEU enabled a significant reduction in pain and anxiety with high overall satisfaction.
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Rodriguez I, Zaluski D, Jodelet PA, Lescaille G, Toledo R, Boucher Y. Effectiveness and patient satisfaction of dental emergencies in Pitié Salpêtrière Hospital, Paris, during the COVID 19 pandemic. J Dent Anesth Pain Med 2022; 22:255-266. [PMID: 35991364 PMCID: PMC9358271 DOI: 10.17245/jdapm.2022.22.4.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background A previous study reported the effectiveness and patient satisfaction in the dental emergency unit (DEU) of the Pitie Salpetrière Hospital in Paris before coronavirus disease 2019 (COVID-19). The same methodology was used during the COVID-19 pandemic to compare pain, anxiety, and patient satisfaction during the two periods. Methods This prospective study was conducted in 2020 (NCT04354272) on adult patients. Data were collected on day zero (D0) on site and then by phone during the daytime on day one (D1), day three (D3), and day seven (D7). The primary objective was to assess the pain intensity at D1. Secondary objectives were to assess pain intensity at D3 and D7, anxiety intensity at D1, D3, and D7, and patient satisfaction. Patients were evaluated on a 0-10 numeric scale on D1, D3, and D7; mean scores were compared with non-parametric statistics (ANOVA, Dunn’s). Results A total of 445 patients were given the opportunity to participate in the study, and 370 patients consented. Seventy-one were lost during follow-up. Ultimately, 299 patients completed all the questionnaires and were included in the analysis. In the final sample (60% men, 40% women, aged 39 ± 14 years), 94% had health insurance. The mean pain scores were: D0, 6.1 ± 0.14; D1, 3.29 ± 0.16; D3, 2.08 ± 0.16; and D7, 1.07 ± 0.35. This indicates a significant decrease of 46%, 67%, and 82% at D1, D3, and D7, respectively, when compared to D0 (P < 0.0001). The mean anxiety scores were D0, 4.7 ± 0.19; D1, 2.6 ± 0.16; D3, 1.9 ± 0.61; and D7, 1.4 ± 0.15. This decrease was significant between D0 and D7 (ANOVA, P < 0.001). Perception of general health improved between D1 and D7. The overall satisfaction was 9.3 ± 0.06. Conclusion DEU enabled a significant reduction in pain and anxiety with high overall satisfaction during COVID-19, which was very similar to levels observed pre-COVID-19 pandemic.
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Affiliation(s)
- Isabelle Rodriguez
- UFR d’Odontologie, Université Paris Cité, France
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | | | | | - Géraldine Lescaille
- UFR d’Odontologie, Université Paris Cité, France
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Rafael Toledo
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Yves Boucher
- Service d’Odontologie, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
- Université Paris Cité, LabNOF, Paris, France
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Lindmark U, Bülow PH, Mårtensson J, Rönning H. The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review. Nurs Open 2019; 6:664-675. [PMID: 31367388 PMCID: PMC6650790 DOI: 10.1002/nop2.249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 12/03/2018] [Accepted: 01/15/2019] [Indexed: 11/20/2022] Open
Abstract
AIMS To continuing the quest of the concept of transition in nursing research and to explore how the concept of transition is used in occupational therapy, oral health and social work as well as in interdisciplinary studies in health and welfare, between 2003-2013. DESIGN An integrative literature review. METHODS PubMed, CINAHL, PsycINFO, DOSS, SocIndex, Social Science Citation Index and AMED databases from 2003-2013 were used. Identification of 350 articles including the concept of transition in relation to disciplines included. Assessment of articles are in accordance to Meleis' typologies of transition by experts in each discipline. Chosen key factors were entered into Statistical Package for the Social Sciences (SPSS). RESULTS Meleis' four typologies were found in all studied disciplines, except development in oral health. The health-illness type was the most commonly explored, whereas in social work and in occupation therapy, situational transitions dominated.
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Affiliation(s)
- Ulrika Lindmark
- Department of Natural Science and Bio Medicine, Center for Oral Health, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Pia H. Bülow
- Department of Social Work, School of Health and WelfareJönköping UniversityJönköpingSweden
- Department of Social WorkUniversity of the Free StateBloemfonteinSouth Africa
| | - Jan Mårtensson
- Department of Nursing, School of Health and WelfareJönköping UniversityJönköpingSweden
| | - Helén Rönning
- School of Health and WelfareJönköping UniversityJönköpingSweden
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Adequacy and clarity of information on out-of-hours emergency dental services at Greater Manchester NHS dental practices: a cross-sectional study. Br Dent J 2017; 222:463-465. [DOI: 10.1038/sj.bdj.2017.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/08/2022]
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Alnaggar D, Andersson L. Emergency management of traumatic dental injuries in 42 countries. Dent Traumatol 2014; 31:89-96. [DOI: 10.1111/edt.12155] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Doaa Alnaggar
- Department of Surgical Sciences; Faculty of Dentistry; Health Sciences Center; Kuwait University; Kuwait City Kuwait
| | - Lars Andersson
- Department of Surgical Sciences; Faculty of Dentistry; Health Sciences Center; Kuwait University; Kuwait City Kuwait
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Dental guidance for all. Br Dent J 2013; 214:432-3. [DOI: 10.1038/sj.bdj.2013.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Austin R, Jones K, Wright D, Donaldson N, Gallagher JE. Use of the out-of-hours emergency dental service at two south-east London hospitals. BMC Oral Health 2009; 9:19. [PMID: 19630986 PMCID: PMC2729730 DOI: 10.1186/1472-6831-9-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 07/25/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prior to the introduction of the 2006 NHS dental contract in England and Wales, general dental practitioners (GDPs) were responsible for the provision of out-of-hours (OOH) emergency dental services (EDS); however there was great national variation in service provision. Under the contractual arrangements introduced 1st April 2006, local commissioning agencies became formally responsible for the provision of out-of-hours emergency dental services. This study aimed to examine patients' use of an out-of-hours emergency dental service and to determine whether the introduction of the 2006 national NHS dental contract had resulted in a change in service use, with a view to informing future planning and commissioning of care. METHODS A questionnaire was administered to people attending the out-of-hours emergency dental service at two inner city London hospitals over two time periods; four weeks before and six months after the introduction of the dental contract in April 2006. The questionnaire explored: reasons for attending; dental registration status and attendance; method of access; knowledge and use of NHS Direct; satisfaction with the service; future preferences for access and use of out-of-hours dental services. Data were compared to determine any impact of the new contract on how and why people accessed the emergency dental service. RESULTS The response rate was 73% of attendees with 981 respondents for the first time period and 546 for the second. There were no significant differences between the two time periods in the gender, age, ethnic distribution or main language of service users accessing the service. Overall, the main dental problem was toothache (72%) and the main reason for choosing this service was due to the inability to access another emergency dental service (42%). Significantly fewer service users attended the out-of-hours emergency dental service during the second period because they could not get an appointment with their own dentist (p = 0.002 from 28% to 20%) and significantly more service users in the second period felt the emergency dental service was easier to get to than their own dentist (P = 0.003 from 8% to 14%). Service users found out about the service from multiple sources, of which family and friends were the most common source (30%). In the second period fewer service users were obtaining information about the service from dental receptionists (P = 0.002 from 14% to 9%) and increased use of NHS Direct for a dental problem was reported (P = 0.002 from 16% to 22%) along with more service users being referred to the service by NHS Direct (P = 0.02 from 19% to 24%). The most common preference for future emergency dental care was face-to-face with a dentist (79%). CONCLUSION This study has provided an insight into how and why people use an out-of-hours emergency dental service and has helped to guide future commissioning of these services. Overall, the service was being used in much the same way both before and after the 2006 dental contract. Significantly more use was being made of NHS Direct after April 2006; however, informal information networks such as friends and family remain an important source of information about accessing emergency dental services.
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Affiliation(s)
- Rupert Austin
- Department of Oral Health Services Research and Dental Public Health, Kings College London Dental Institute, Caldecot Road, London, SE5 9RW, UK
| | - Kate Jones
- Department of Oral Health Services Research and Dental Public Health, Kings College London Dental Institute, Caldecot Road, London, SE5 9RW, UK
- NHS Southwark Primary Care Trust, Mabel Goldwin House, 49 Grange Walk, London, SE1 3DY, UK
| | - Desmond Wright
- Department of Oral Health Services Research and Dental Public Health, Kings College London Dental Institute, Caldecot Road, London, SE5 9RW, UK
- NHS Lewisham Primary Care Trust, Cantilever House, Eltham Road, Lee, London, SE12 8RN, UK
| | - Nora Donaldson
- Unit of Biostatistics, King's College London Dental Institute, Caldecot Road, London, SE5 9RW, UK
| | - Jennifer E Gallagher
- Department of Oral Health Services Research and Dental Public Health, Kings College London Dental Institute, Caldecot Road, London, SE5 9RW, UK
- NHS Lambeth Primary Care Trust, 1 Lower Marsh, Waterloo, London, SE1 7NT, UK
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Tulip DE, Palmer NOA. A retrospective investigation of the clinical management of patients attending an out of hours dental clinic in Merseyside under the new NHS dental contract. Br Dent J 2008; 205:659-64; discussion 648. [DOI: 10.1038/sj.bdj.2008.1044] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2008] [Indexed: 11/09/2022]
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Out-of-hours emergency dental services in Scotland – a national model. Br Dent J 2008; 205:485-7. [DOI: 10.1038/sj.bdj.2008.936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2008] [Indexed: 11/09/2022]
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Portman-Lewis S. An Analysis of the Out-of-Hours Demand and Treatment Provided by a General Dental Practice Rota over a Five-Year Period. ACTA ACUST UNITED AC 2007; 14:98-104. [PMID: 17650385 DOI: 10.1308/135576107781327043] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective To obtain information about the frequency of call-outs, relative frequency of different types of dental emergencies that presented, and treatment provided between 1999 and 2003 by an out-of-hours on-call rota run by a cooperative of 12 dentists in Herefordshire. Method A retrospective analysis was undertaken of the data recorded in the on-call log of the cooperative from March 1999 to December 2003. Data recorded were: date of call, time of call, dentist on call, contract type (National Health Service, Denplan, other capitation scheme, private fee-per-item-of-service, or unregistered), time seen, nature of complaint and treatment provided. Results The log produced 1070 usable entries. The gender mix of patients seeking care was 61% female and 39% male. Most call-outs were on Saturday; the next most frequent days were Sunday and Friday. The most common presenting complaint was ‘toothache’ in the form of acute pulpitis or periapical periodontitis, which together accounted for 52.3% of all calls. The next most frequent complaints were: broken or lost tooth, lost or fractured restorations and fractured teeth, which accounted for a further 27.7% of all calls. The most serious presenting complaints, avulsion or postoperative bleeding, accounted for 0.5% and 1.3% of the calls, respectively. One hundred and ninety-six (18.3%) of the callers were not subsequently seen in person, 39 of whom were not seen because they were private patients who declined to pay the call-out fee. The other 157 unseen patients (14.7%) appeared to be happy just to receive advice over the telephone. Of patients who were seen, 62.9% were seen within one hour and only 9.2% waited longer than two hours. Some patients who telephoned late on a Friday or Saturday were happy to wait until the next morning. Conclusions The most common dental emergency with which patients presented at an emergency rota service was periapical periodontitis, followed by pulpitis and fractured tooth. The treatments most commonly provided were extirpation of the pulp, temporary dressing or advice only.
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