1
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Ng E, Tay JRH, Boey SK, Laine ML, Ivanovski S, Seneviratne CJ. Antibiotic resistance in the microbiota of periodontitis patients: an update of current findings. Crit Rev Microbiol 2024; 50:329-340. [PMID: 37140235 DOI: 10.1080/1040841x.2023.2197481] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/16/2023] [Indexed: 05/05/2023]
Abstract
Systemic antibiotics are an effective adjunct in the treatment of periodontitis, but their judicious use is necessary as antimicrobial resistance is a growing global concern. This review aims to explore the current understanding and insight related to antibiotic resistance in the subgingival microbiota of periodontitis patients. A search of MEDLINE (PubMed) was carried out from 1 January 2012 to 25 November 2021 for studies related to antibiotic resistance in periodontitis patients. Of the 90 articles identified, 12 studies were selected for inclusion. A significant incidence of antibiotic resistant isolates was reported for Porphyromonas gingivalis, Prevotella intermedia, Prevotella denticola, Prevotella melaninogenica, Fusobacterium nucleatum, Tanerella forsythia, Aggretibacter actinomycetemcomitans, Streptococcus constellatus, Streptococcus intermedius, and Parvimonas micra, but resistance to specific antibiotics did not reach above 10% of isolates in most studies except for amoxicillin resistance in Aggretibacter actinomycetemcomitans. The highest frequency of resistance across all bacterial species was for amoxicillin, clindamycin, and metronidazole. However, resistance patterns were widely variable across geographical locations, and the high heterogeneity between antibiotic-resistant isolates across studies precludes any clinical recommendations from this study. Although antibiotic resistance has yet to reach critical levels in periodontitis patients, an emphasis on antibiotic stewardship interventions such as point-of-care diagnostics and education for key stakeholders is needed to curb a growing problem.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - Sean Kuan Boey
- Discipline of Periodontics, National University of Singapore, Singapore
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sašo Ivanovski
- School of Dentistry, The University of Queensland, Brisbane, Australia
- School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, Australia
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, Australia
- School of Dentistry, Center for Oral-facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
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2
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Cimiano P, Collins B, De Vuono MC, Escudier T, Gottowik J, Hartung M, Leddin M, Neupane B, Rodriguez-Esteban R, Schmidt AL, Starke-Knäusel C, Voorhaar M, Wieckowski K. Patient listening on social media for patient-focused drug development: a synthesis of considerations from patients, industry and regulators. Front Med (Lausanne) 2024; 11:1274688. [PMID: 38515987 PMCID: PMC10955474 DOI: 10.3389/fmed.2024.1274688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/12/2024] [Indexed: 03/23/2024] Open
Abstract
Patients, life science industry and regulatory authorities are united in their goal to reduce the disease burden of patients by closing remaining unmet needs. Patients have, however, not always been systematically and consistently involved in the drug development process. Recognizing this gap, regulatory bodies worldwide have initiated patient-focused drug development (PFDD) initiatives to foster a more systematic involvement of patients in the drug development process and to ensure that outcomes measured in clinical trials are truly relevant to patients and represent significant improvements to their quality of life. As a source of real-world evidence (RWE), social media has been consistently shown to capture the first-hand, spontaneous and unfiltered disease and treatment experience of patients and is acknowledged as a valid method for generating patient experience data by the Food and Drug Administration (FDA). While social media listening (SML) methods are increasingly applied to many diseases and use cases, a significant piece of uncertainty remains on how evidence derived from social media can be used in the drug development process and how it can impact regulatory decision making, including legal and ethical aspects. In this policy paper, we review the perspectives of three key stakeholder groups on the role of SML in drug development, namely patients, life science companies and regulators. We also carry out a systematic review of current practices and use cases for SML and, in particular, highlight benefits and drawbacks for the use of SML as a way to identify unmet needs of patients. While we find that the stakeholders are strongly aligned regarding the potential of social media for PFDD, we identify key areas in which regulatory guidance is needed to reduce uncertainty regarding the impact of SML as a source of patient experience data that has impact on regulatory decision making.
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Affiliation(s)
- Philipp Cimiano
- Semalytix GmbH, Bielefeld, Germany
- CITEC, Bielefeld University, Bielefeld, Germany
| | - Ben Collins
- Boehringer Ingelheim International GmbH, Ingelheim, Germany
| | | | | | - Jürgen Gottowik
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | | | - Mathias Leddin
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Bikalpa Neupane
- Takeda Pharmaceuticals Co., Ltd., Cambridge, MA, United States
| | | | - Ana Lucia Schmidt
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
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3
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Hamilton RA, Lond B, Wilde L, Williamson I. Understanding the lived-experience and support-needs of people living with antimicrobial resistance in the UK through interpretative phenomenological analysis. Sci Rep 2024; 14:3403. [PMID: 38337017 PMCID: PMC10858033 DOI: 10.1038/s41598-024-53814-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/05/2024] [Indexed: 02/12/2024] Open
Abstract
In the UK nearly 54,000 infections were caused by serious resistant bacteria in 2022 but there is a lack of evidence regarding the long-term impact on patients' lives nor what support they need. This research aimed to answer the question: "What are the key elements of experience and support needs of people living with AMR in the UK?". In-depth semi-structured interviews were undertaken with nine people who had been living with resistant infections or colonisation for 12-months or longer. Interpretive Phenomenological Analysis was used to study the accounts and illustrate individuals' experiences and support-needs. Participants experienced marginalisation and isolation but also empowerment; described across three major themes: (1) I live in fear and stigma: The long-term impact of AMR; (2) I am battling on my own: A journey toward self-advocacy; and (3) I like to share my story: The role of AMR communities. All participants perceived a lack of knowledge, information, and support from clinicians; difficulties accessing reliable and understandable information; and lack of understanding from family and friends. Charities and online groups provided support with coping with their situation and improving mental health and wellbeing. Understandable and relatable information regarding the science of AMR, transmission, prevention, and living with AMR needs to be provided by clinicians and healthcare services around the time of diagnosis to readily available after diagnosis.
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Affiliation(s)
| | - Benjamin Lond
- Department of Psychology, De Montfort University, Leicester, UK
| | - Lucina Wilde
- School of Pharmacy, De Montfort University, Leicester, UK
| | - Iain Williamson
- Department of Psychology, De Montfort University, Leicester, UK
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4
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Wright JT. Critical challenges facing dentistry. J Am Dent Assoc 2024; 155:1-2. [PMID: 37988045 DOI: 10.1016/j.adaj.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
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5
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Farrokhi F, Ghorbani Z, Farrokhi F, Namdari M, Salavatian S. Social media as a tool for oral health promotion: A systematic review. PLoS One 2023; 18:e0296102. [PMID: 38113216 PMCID: PMC10729958 DOI: 10.1371/journal.pone.0296102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023] Open
Abstract
Social media platforms are common means of sharing information, personal experiences, and lifestyle. They can also be utilized as cost-effective methods for individuals to acquire health information and promote oral health. The purpose of the present study was to systematically review the current literature on the interventions taken through social media for promoting lay people's oral health. This systematic review (PROSPERO: CRD42023395005) followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines. A comprehensive search was conducted in four electronic databases (PubMed, Scopus, Embase, and Cochrane Library) for relevant articles published between 2012 and 2023. Data such as study design, sample size, follow-up duration, utilized social media platforms and main findings were extracted from the eligible studies. The quality of the studies included in the systematic review was evaluated by the quality assessment tools for intervention studies recommended by the National Collaborating Centre for Methods and Tools. Out of the 1934 records identified in the initial search, 10 studies met the inclusion criteria and were included in the qualitative synthesis. These studies comprised seven randomized control trials, one field trial and two quasi-experimental. Various social media platforms, including Telegram, Instagram, YouTube, WhatsApp and Snapchat, were used for communication with patients. Some studies solely utilized social media interventions, while others combined online and traditional interventions. The quality assessment categorized 30% of the studies as "strong", 50% as "moderate", and the remaining as "weak". The implementation of social media interventions positively influenced multiple aspects of oral health among the laypeople. Online platforms such as YouTube, WhatsApp, Instagram, and Telegram can be effectively utilized to promote oral health among patients.
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Affiliation(s)
- Farzaneh Farrokhi
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Ghorbani
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Farrokhi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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6
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Sneddon J, Thompson W, Kpobi LNA, Ade DA, Sefah IA, Afriyie D, Goldthorpe J, Turner R, Nawaz S, Wilson S, Hart J, Byrne-Davis L. Exploring the Use of Antibiotics for Dental Patients in a Middle-Income Country: Interviews with Clinicians in Two Ghanaian Hospitals. Antibiotics (Basel) 2022; 11:antibiotics11081081. [PMID: 36009950 PMCID: PMC9404843 DOI: 10.3390/antibiotics11081081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Antimicrobial resistance is a global problem driven by the overuse of antibiotics. Dentists are responsible for about 10% of antibiotics usage across healthcare worldwide. Factors influencing dental antibiotic prescribing are numerous, with some differences in low- and middle-income countries compared with high-income countries. This study aimed to explore the antibiotic prescribing behaviour and knowledge of teams treating dental patients in two Ghanaian hospitals. Methods: Qualitative interviews were undertaken with dentists, pharmacists, and other healthcare team members at two hospitals in urban and rural locations. Thematic and behaviour analyses using the Actor, Action, Context, Target, Time framework were undertaken. Results: Knowledge about ‘antimicrobial resistance and antibiotic stewardship’ and ‘people and places’ were identified themes. Influences on dental prescribing decisions related to the organisational context (such as the hierarchical influence of colleagues and availability of specific antibiotics in the hospital setting), clinical issues (such as therapeutic versus prophylactic indications and availability of sterile dental instruments), and patient issues such as hygiene in the home environment, delays in seeking professional help, ability to access antibiotics in the community without a prescription and patient’s ability to pay for the complete prescription. Conclusions: This work provides new evidence on behavioural factors influencing dental antibiotic prescribing, including resource constraints which affect the availability of certain antibiotics and diagnostic tests. Further research is required to fully understand their influence and inform the development of new approaches to optimising antibiotic use by dentists in Ghana and potentially other low- and middle-income countries.
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Affiliation(s)
- Jacqueline Sneddon
- Healthcare Improvement Scotland, Glasgow G1 2NP, UK
- British Society for Antimicrobial Chemotherapy, Birmingham B1 3NJ, UK
- Correspondence:
| | - Wendy Thompson
- Division of Dentistry, University of Manchester, Manchester M13 9PL, UK
| | - Lily N. A. Kpobi
- Regional Institute for Population Studies, University of Ghana, Legon, Accra P.O. Box LG25, Ghana
| | - Diana Abena Ade
- Regional Institute for Population Studies, University of Ghana, Legon, Accra P.O. Box LG25, Ghana
| | - Israel Abebrese Sefah
- Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Ho P.O. Box PMB31, Ghana
- Keta Municipal Hospital, Keta-Dzelukope P.O. Box WT82, Ghana
| | | | - Joanna Goldthorpe
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Rebecca Turner
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Saher Nawaz
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Shona Wilson
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Jo Hart
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
| | - Lucie Byrne-Davis
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK
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7
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Yashpal S, Raghunath A, Gencerliler N, Burns LE. Exploring Public Perceptions of Dental Care Affordability in the United States: A Mixed Method Analysis via Twitter. JMIR Form Res 2022; 6:e36315. [PMID: 35658090 PMCID: PMC9288095 DOI: 10.2196/36315] [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: 01/18/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dental care expenses are reported to present higher financial barriers than any other type of health care service in the United States. Social media platforms such as Twitter have become a source of public health communication and surveillance. Previous studies have demonstrated the usefulness of Twitter in exploring public opinion on aspects of dental care. To date, no studies have leveraged Twitter to examine public sentiments regarding dental care affordability in the U.S. OBJECTIVE The aim of this study was to understand public perceptions of dental care affordability in the U.S. on the social media site, Twitter. METHODS Tweets posted between September 1, 2017 and September 30, 2021 were collected using the Snscrape application. Query terms were selected a priori to represent dentistry and financial aspects associated with dental treatment. Data were analyzed qualitatively using both deductive and inductive approaches. Ten percent of all included tweets were coded to identify prominent themes and subthemes. The entire sample of included tweets were then independently coded into the thematic categories. Quantitative data analyses included: geographic distribution of tweets by state; volume analysis of tweets over time; distribution of tweets by content theme. RESULTS A final sample of 5,314 tweets were included in the study. Thematic analysis identified the following prominent themes: 1) general sentiments (1614 tweets, 30.4%); 2) delaying or forgoing dental care (1190 tweets, 22.4%); 3) payment strategies (1019 tweets, 19.2%); 4) insurance (767 tweets, 14.4%); and 5) policy statements (724 tweets, 13.6%). Geographic distributions of tweets established California, Texas, Florida, New York as the states with the most tweets. A word cloud revealed that "insurance", "need", and "work" were the most frequently used words. Qualitative analysis revealed barriers faced by individuals to accessing dental care, strategies taken to cope with dental pain, and public perceptions on aspects of dental care policy. The volume and thematic trends of tweets corresponded to relevant societal events: The Coronavirus disease 2019 (COVID-19) pandemic and debates on healthcare policy resulting from the election of President Joseph R. Biden. CONCLUSIONS Findings illustrate the real-time sentiment of social media users toward the cost of dental treatment and suggest shortcomings in funding that may be representative of greater systemic failures in the provision of dental care. Thus, this study provides insights for policy makers and dental professionals who strive to increase access to dental care.
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Affiliation(s)
| | | | - Nihan Gencerliler
- Department of Endodontics, College of Dentistry, New York University, 345 E. 24th Street, New York, US
| | - Lorel E Burns
- Department of Endodontics, College of Dentistry, New York University, 345 E. 24th Street, New York, US
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8
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Thompson W, Howe S, Pitkeathley C, Coull C, Teoh L. Outcomes to evaluate care for adults with acute dental pain and infection: a systematic narrative review. BMJ Open 2022; 12:e057934. [PMID: 35190445 PMCID: PMC8860024 DOI: 10.1136/bmjopen-2021-057934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To identify outcomes reported in peer-reviewed literature for evaluating the care of adults with acute dental pain or infection.DesignSystematic narrative review. SETTING/PARTICIPANTS Primary research studies published in peer-reviewed literature and reporting care for adults with acute dental pain or infection across healthcare settings. Reports not in English language were excluded. STUDY SELECTION Seven databases (CINAHL Plus, Dentistry and Oral Sciences Source, EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science) were searched from inception to December 2020. Risk of bias assessment used the Critical Appraisal Skills Programme checklist for randomised controlled trials and Quality Assessment Tool for Studies of Diverse Design for other study types. OUTCOMES Narrative synthesis included all outcomes of care for adults with acute dental pain or infection. Excluded were outcomes about pain management to facilitate treatment, prophylaxis of postsurgical pain/infection or traumatic injuries. RESULTS Searches identified 19 438 records, and 27 studies (dating from 1993 to 2020) were selected for inclusion. Across dental, pharmacy, hospital emergency and rural clinic settings, the studies were undertaken in high-income (n=20) and low/middle-income (n=7) countries. Two clinical outcome categories were identified: signs and symptoms of pain/infection and complications following treatment (including adverse drug reactions and reattendance for the same problem). Patient-reported outcomes included satisfaction with the care. Data collection methods included patient diaries, interviews and in-person reviews. DISCUSSION A heterogeneous range of study types and qualities were included: one study, published in 1947, was excluded only due to lacking outcome details. Studies from dentistry reported just clinical outcomes; across wider healthcare more outcomes were included. CONCLUSIONS A combination of clinical and patient-reported outcomes are recommended to evaluate care for adults with acute dental pain or infection. Further research is recommended to develop core outcomes aligned with the international consensus on oral health outcomes. PROSPERO REGISTRATION NUMBER CRD42020210183.
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Affiliation(s)
- Wendy Thompson
- The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
| | - Shaun Howe
- Public Dental Service, NHS Shetland, Lerwick, UK
| | | | - Carly Coull
- Oral and Maxillofacial Services, Manchester University NHS Foundation Trust, Manchester, UK
| | - L Teoh
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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9
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Khan FU, Khan A, Shah S, Hayat K, Usman A, Khan FU, Khan Z, Karataş Y, Ahmad T, Chang J, Malik UR, Khan A, Shukar S, Kadirhaz M, Fang Y. Exploring Undergraduate Pharmacy Students Perspectives Towards Antibiotics Use, Antibiotic Resistance, and Antibiotic Stewardship Programs Along With the Pharmacy Teachers' Perspectives: A Mixed-Methods Study From Pakistan. Front Pharmacol 2021; 12:754000. [PMID: 34819859 PMCID: PMC8606649 DOI: 10.3389/fphar.2021.754000] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Antibiotic resistance (ABR) is one of the major issues around the globe. Timely education and awareness of pharmacy students regarding the appropriate use of antibiotics, ABR, and antimicrobial stewardships are required. Methods: The present study was first conducted in 12 (public and private sector) universities among undergraduate pharmacy students (UGPS) (n = 414) irrespective of their study year through a validated questionnaire, and the insights of pharmacy teachers were taken through in-depth semi-structured interviews in the second phase. For the quantitative data, different statistical methods were used, and data were presented in tabulated form, whereas inductive thematic interpretation was used to categorize themes and derive conclusions from qualitative evidence. Results: The majority of the students were males (n = 223, 54%) with the mean age group 19–23 years, and 20 faculty members were interviewed with a mean duration of 15 min. Students have good knowledge about antibiotics use and the majority purchased antibiotics through prescription (n = 277, 66.9%) during the last month and strongly agreed to stop unnecessary household storage (n = 183 44.2%). Most of the students have heard the terminologies related to antimicrobial resistance through social media while unaware (n = 104, 25.1%) of a Pakistan national action plan against AMR (antimicrobial resistance). Overall, respondents have a somewhat good understanding of the ABR. Regular use of antibiotics without consultation of a physician can lead to ABR and some wrong answers were observed (162, 39.1%; p > 0.05). The majority of the students (n = 198, 47.8%) and teachers believe that the current pharmacy syllabus must be swiftly updated with the new subjects related to ABR and AMS (antimicrobial stewardship) in Pakistan. The UGPS have emphasized (n = 220, 53.1%; Median = 1, IQR = 2) establishing a link between academia and hospitals. The ABR issue has been highlighted by pharmacy faculty members, who have urged students to take practical efforts toward ABR and AMS knowledge. Conclusion: The UGPS knowledge related to ABR and AMS must be updated. Students at the undergraduate level must get training in order to encourage the sensible use of antibiotics. Courses on ABR and AMS should be included in present pharmacy curricula.
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Affiliation(s)
- Faiz Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China
| | - Amjad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Shahid Shah
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China.,Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Abubakar Usman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
| | - Farman Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China
| | - Zakir Khan
- Department of Pharmacology, Institute of Health Sciences, Çukurova University, Adana, Turkey
| | - Yusuf Karataş
- Department of Pharmacology, Institute of Health Sciences, Çukurova University, Adana, Turkey
| | - Tawseef Ahmad
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad, Pakistan
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China
| | - Usman Rashid Malik
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China
| | - Asad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sundus Shukar
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China
| | - Muhtar Kadirhaz
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi'an, China
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10
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Thompson W. Spread awareness; stop resistance. Br Dent J 2021; 231:531. [PMID: 34772997 PMCID: PMC8588754 DOI: 10.1038/s41415-021-3618-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Wendy Thompson
- Elected Member of the FDI World Dental Federation Science Committee and Chair of its Antimicrobial Resistance Group; Member of the BDA Health & Science Committee; Clinical Academic GDP, University of Manchester and {my}dentist Kirkby Lonsdale, UK
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11
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Thompson W, Sandoe J, Pavitt S, Walsh T, Byrne-Davis L. Co-Developing an Antibiotic Stewardship Tool for Dentistry: Shared Decision-Making for Adults with Toothache or Infection. Antibiotics (Basel) 2021; 10:antibiotics10111345. [PMID: 34827283 PMCID: PMC8615064 DOI: 10.3390/antibiotics10111345] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
Dentistry is responsible for around 10% of antibiotic prescribing across global healthcare, with up to 80% representing inappropriate use. Facilitating shared decision-making has been shown to optimise antibiotic prescribing (antibiotic stewardship) in primary medical care. Our aim was to co-develop a shared decision-making antibiotic stewardship tool for dentistry. Dentists, patients and other stakeholders prioritised factors to include in the new tool, based on previous research (a systematic review and ethnographic study) about dentists’ decision-making during urgent appointments. Candidate behaviour-change techniques were identified using the Behaviour Change Wheel and selected based on suitability for a shared decision-making approach. A ‘think aloud’ study helped fine-tune the tool design and Crystal Marking ensured clarity of messaging. The resulting paper-based worksheet for use at point-of-care incorporated various behaviour change techniques, such as: ’information about (and salience of) health consequences’, ‘prompts and cues’, ‘restructuring the physical (and social) environment’ and ‘credible sources’. The think aloud study confirmed the tool’s acceptability to dentists and patients, and resulted in the title: ‘Step-by-step guide to fixing your toothache.’ Further testing will be necessary to evaluate its efficacy at safely reducing dental antibiotic prescribing during urgent dental appointments in England and, with translation, to other dental contexts globally.
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Affiliation(s)
- Wendy Thompson
- Division of Dentistry, University of Manchester, Manchester M13 9PL, UK;
- School of Dentistry, University of Leeds, Leeds LS2 9JT, UK;
- Correspondence: ; Tel.: +44-7837-190-387
| | | | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds LS2 9JT, UK;
| | - Tanya Walsh
- Division of Dentistry, University of Manchester, Manchester M13 9PL, UK;
| | - Lucie Byrne-Davis
- Division of Medical Education, University of Manchester, Manchester M13 9PL, UK;
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Powell HE. Dentists deployed: an insider's perspective of life on the NHS front line. Prim Dent J 2021; 10:21-29. [PMID: 34727769 DOI: 10.1177/20501684211034013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The COVID-19 pandemic has stretched and overburdened healthcare services within the UK. This national crisis has led to the widespread redeployment of healthcare workers and reorganization of services throughout the NHS in the UK. The flexible and altruistic nature of healthcare workers has been inspiring, and central in the UK's response to the COVID-19 pandemic. This article describes the 'first-hand' experience of a secondary care dentist, highlighting the redeployment journey to the emergency department (ED) of a major trauma hospital in the North-West of England during the first wave of the COVID-19 pandemic.
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Affiliation(s)
- Harriet E Powell
- Specialty Dentist, Paediatric Dentistry, Manchester Dental Hospital, UK
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Trends in Antibiotic Self-Medication for Dental Pathologies among Patients in the Dominican Republic: A Cross-Sectional Study. J Clin Med 2021; 10:jcm10143092. [PMID: 34300258 PMCID: PMC8308055 DOI: 10.3390/jcm10143092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/05/2021] [Accepted: 07/11/2021] [Indexed: 11/21/2022] Open
Abstract
The World Health Organisation has warned of the increase in antibiotic resistance, estimating that by 2050 it could become the leading cause of death worldwide. Several studies and literature reviews show a correlation between antibiotic use and bacterial resistance, with unnecessary broad-spectrum antibiotics, such as amoxicillin/clavulanic acid and azithromycin, being one of the main causative factors. An interview-based survey of 2160 participants was conducted to assess the prevalence in the practice of self-medication with antibiotics among dental patients in the Dominican Republic. A series of open-ended questions regarding self-medication and class of antibiotics were put to the patients. Over a third of the study population (39.7%) admitted to the practice of antibiotic self-medication. Most of the respondents (58.4%) who indulged in self-medication were females, and it was prevalent in the older adults between 32–42 years old (36%). There was a negative correlation between age and self-medication practice (p < 0.001) observed with point biserial correlation test. Binary logistic regression analysis found an odds ratio of 0.97 (p < 0.001). The most consumed antibiotics were amoxicillin/clavulanic acid (52%), amoxicillin (31.1%), and azithromycin (10.1%). It is imperative to educate patients about the harmful effects of self-medication and to stress the need for governments to implement stricter laws on non-prescription drug availability.
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