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Shaath H, Salman B, Daghistani D, Koutaich R, Alhammadi A, Yakoub N, Awad MA. A Pilot Study of Preparedness of Dentists in the United Arab Emirates to Deal with Medical Emergencies. Eur J Dent 2023; 17:749-755. [PMID: 37059445 PMCID: PMC10569866 DOI: 10.1055/s-0042-1755628] [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: 04/16/2023] Open
Abstract
OBJECTIVES The purpose of this pilot study is to assess the United Arab Emirates dentists' preparedness to manage medical emergencies. MATERIALS AND METHODS Ninety-seven licensed dentists participated in this study. Dentists responded to self-administrated questionnaires that contained 23 questions divided into five parts. The first part collected data on participants' sex, years of experience, and whether they are general dental practitioner (GDP) or specialists. The second part included seven questions that asked participants to indicate if they took medical history, obtained vital signs, and attended basic life support courses. The third part included six multiple choice questions regarding the availability of emergency drugs in the dental clinic. The fourth part consisted of three multiple-choice questions that assessed the dentists' immediate response to a medical emergency. Finally, the fifth part comprised four questions to evaluate the dentists' knowledge of proper treatment of special emergency cases they may encounter in the dental offices. RESULTS Out of the 97 participants, only 51% (N = 49) indicated that they can handle emergencies such as anaphylactic shock and syncope in the dental office. The majority of the dentists (80%) indicated that they have emergency kits. Only 46% of the specialists and 42% of the GDPs were able to correctly plan extractions in a patient with a prosthetic heart valve. Less than half of the participants (N = 35, 36%) were able to correctly answer the question regarding management of a foreign-body aspiration by attempting Heimlich/Triple maneuver. CONCLUSIONS Within the limitations of this study, dentists need further hands-on training to improve their skills and knowledge about medical emergencies that could occur in the dental settings. Furthermore, we recommend that guidelines should be available in the clinic to strengthen the dentists' ability to deal with medical emergencies.
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Affiliation(s)
- Helmi Shaath
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Basheer Salman
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Dalia Daghistani
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Rayan Koutaich
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Alya Alhammadi
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Nermeen Yakoub
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Manal A. Awad
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
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Diz Dios P, Monteiro L, Pimolbutr K, Gobbo M, France K, Bindakhil M, Holmes H, Sperotto F, Graham L, Turati F, Salvatori A, Hong C, Sollecito TP, Lodi G, Thornhill MH, Lockhart PB, Edefonti V. World Workshop on Oral Medicine VIII: Dentists' compliance with infective endocarditis prophylaxis guidelines for patients with high-risk cardiac conditions: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:757-771. [PMID: 37105883 DOI: 10.1016/j.oooo.2022.12.017] [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: 11/14/2022] [Accepted: 12/14/2022] [Indexed: 03/07/2023]
Abstract
OBJECTIVE To determine dentists' awareness and/or adherence to antibiotic prophylaxis (AP) guidelines for preventing infective endocarditis (IE) in patients with high-risk heart conditions. STUDY DESIGN A systematic literature review was performed on MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, Proquest, Embase, Dentistry, and Oral Sciences Source databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Nationwide studies based on questionnaires, surveys, and interviews completed by dentists and published since 2007 were included. RESULTS From 2907 articles screened, 28 studies were selected (across 20 countries). The quality of included studies was poor due to a lack of standard evaluation tools, low response rates, and lack of questionnaire validity and/or reliability. Approximately 75% of surveyed dentists reported being knowledgeable about AP guidelines, but only ∼25% complied. Reported compliance with American Heart Association (AHA) guidelines was 4 times higher than with the National Institute for Health and Care Excellence (NICE) recommendations. Some of the highest adherence rates were reported for other national AP guidelines. Significant geographic differences were observed in the estimated adherence to AHA guidelines and the percentage of dentists who reported seeking advice from physicians and/or cardiologists. CONCLUSION Rates of compliance and/or adherence were substantially different from rates of knowledge and/or awareness, including relevant geographic dissimilarities. Compliance/adherence was higher for AHA than NICE.
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Affiliation(s)
- Pedro Diz Dios
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), School of Medicine and Dentistry, Santiago de Compostela University, Spain
| | - Luis Monteiro
- University Institute of Health Sciences (CESPU), Portugal
| | | | - Margherita Gobbo
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy.
| | | | | | - Haly Holmes
- Department of Oral Medicine & Periodontology, Faculty of Dentistry University of the Western Cape, South Africa
| | - Francesca Sperotto
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Laurel Graham
- Levy Dental Medicine Library-University of Pennsylvania, USA
| | - Federica Turati
- Branch of Medical Statistics, Biometry, and Epidemiology "G.A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | | | - Catherine Hong
- Faculty of Dentistry, National University of Singapore, Singapore
| | | | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche-Università degli Studi di Milano, Italy
| | | | | | - Valeria Edefonti
- Branch of Medical Statistics, Biometry, and Epidemiology "G.A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy; Branch of Medical Statistics, Biometry, and Epidemiology "G.A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Effect of an educational intervention among Lebanese dentists on antibiotic prescribing: a randomized controlled study. Clin Oral Investig 2022; 26:4857-4869. [DOI: 10.1007/s00784-022-04453-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/12/2022] [Indexed: 11/26/2022]
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Sales N, Sohal KS, Moshy JR, Owibingire SS, Deoglas DK, Laizer PJ. Conscious sedation in dentistry: knowledge and practice among dental professionals in Tanzania. J Dent Anesth Pain Med 2021; 21:557-564. [PMID: 34909473 PMCID: PMC8637913 DOI: 10.17245/jdapm.2021.21.6.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/11/2021] [Accepted: 10/18/2021] [Indexed: 11/15/2022] Open
Abstract
Background Conscious sedation is a useful adjunct in the treatment of patients in dentistry; however, a lack of knowledge among the dental profession regarding sedation is a restricting factor in the practice of dental sedation. Therefore, this study was conducted to assess the knowledge and practice of sedation in dentistry among dental professionals in Tanzania. Methods This was a cross-sectional study conducted for five months targeting all practicing dental professionals in Tanzania. A modified questionnaire contained 14 questions regarding knowledge about sedative agents and a section on the practice of sedation. The data obtained from this study were coded and entered into a computer program and analyzed using SPSS software version 23.0. The data are presented as frequencies and percentages in tables and charts. Statistical significance was set at P < 0.05. Results The age range of participants was between 24 and 63 years (mean 36.6 ± 7.7 years). There were 107 men (78.1%), and the male-to-female ratio was 3.6:1. The majority (76.6%) of participants only had an undergraduate dental degree. Thirty-one percent of participants only worked in publicly owned health facilities. Slightly more than half (59.9%) of participants had satisfactory knowledge regarding sedation in dentistry. There was no statistically significant association between the level of sedation-related knowledge and the demographic characteristics of the participants. Only 21.9% reported using sedation in their practice, and the most commonly used sedative drug was diazepam. The reasons for not using dental sedation in clinical practice included a perceived lack of knowledge on sedation, lack of equipment, and cost. Conclusion Most dental professionals in Tanzania have basic knowledge of sedation in dentistry, although knowledge regarding sedative agents is generally low. The practice of sedation in dentistry in Tanzania is very low compared to that in middle- and high-income countries. Inadequate knowledge, lack of equipment, and the cost of practicing sedation are the main reasons for not practicing sedation.
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Affiliation(s)
- Nicco Sales
- Department of Dental Services, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Karpal Singh Sohal
- Department of Dental Services, Muhimbili National Hospital, Dar es Salaam, Tanzania.,Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jeremiah Robert Moshy
- Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sira Stanslaus Owibingire
- Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - David K Deoglas
- Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paulo J Laizer
- Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Šimundić Munitić M, Šutej I, Ćaćić N, Tadin A, Balić M, Bago I, Poklepović Peričić T. Knowledge and attitudes of Croatian Dentists Regarding Antibiotic Prescription in Endodontics: A Cross-sectional Questionnaire-based Study. Acta Stomatol Croat 2021; 55:346-358. [PMID: 35001930 PMCID: PMC8734455 DOI: 10.15644/asc55/4/2] [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: 08/22/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To assess dentists' level of knowledge and practice concerning antibiotic usage in endodontics using the European Society of Endodontology position statement as a reference. MATERIALS AND METHODS A cross-sectional study was conducted in the form of an electronic questionnaire consisting of 23 questions, including dentists' demographic and professional characteristics, attitudes as well as experiences regarding antibiotics in endodontics. Data were evaluated by the Mann-Whitney test or the Kruskal Wallis 1-way ANOVA, α = 5%. RESULTS The overall mean self-reported knowledge of antibiotics usage in endodontics was 11.7±2.5 points, out of a maximum possible score of 23. The factors associated with a higher knowledge were: age (P≤0.001), clinical experience (P≤0.001), specialist training (P=0.008), and adherence to the guidance on the use of systemic antibiotics in endodontics (P=0.006). Dentists who specialized in endodontics (16.1±2.2) achieved higher levels of knowledge. CONCLUSION Knowledge on antibiotic usage in endodontics among dentists in Croatia is insufficient. There is a need for continuing education on the use of antibiotics among general dentists.
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Affiliation(s)
| | - Ivana Šutej
- Department of Pharmacology, School of Dental Medicine, University of Zagreb, Croatia
| | - Nensi Ćaćić
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | | | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Tina Poklepović Peričić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
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A Survey of Systemic Antibiotic Prescription Patterns Amongst Iraqi Dentists. Int Dent J 2021; 72:338-345. [PMID: 34344542 PMCID: PMC9275136 DOI: 10.1016/j.identj.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 05/18/2021] [Accepted: 06/07/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The misuse of antibiotic prescriptions is a common behavior amongst dentists worldwide. Over-prescription of these agents is associated with multiple adverse effects and risk of developing bacterial resistance. The aim of this study was to assess systemic antibiotic prescription patterns amongst dentists in Iraq. METHODS A questionnaire-based survey was conducted in dental centres distributed in 12 Iraqi governates. The questionnaire was composed of two main sections: The first was dedicated to collecting demographic and work-related information, and the second section included questions seeking details about antibiotic prescriptions for different oral and dental conditions. RESULTS A total of 481 valid questionnaires were considered in the final analysis. The numbers of correct and incorrect patterns of prescribing antibiotics for different dental/oral conditions were almost equal (49.6% and 50.4%, respectively). Amongst independent variables investigated, qualification of the dentist and work domain were found to have significant associations with correct prescribing patterns (odds ratio, 1.166 and 1.197, respectively). The majority of dentists preferred amoxicillin as the first-choice antibiotic, followed by "Augmentin" (43.7% and 35.5%, respectively), whilst clarithromycin was the lowest on the list. Azithromycin was the most recommended antibiotic (55.9%) in cases of allergy to penicillin. CONCLUSIONS In general, antibiotics are prescribed for recommended conditions, but the prescription for nonrecommended conditions was also evident amongst Iraqi dentists. Correct pattern of antibiotic prescribing was significantly associated with specialists and those working in the academic field. Additionally, amoxicillin and its derivatives are the most preferred drugs.
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Al-Mohaissen MA, Al-Mehisen R, Lee T, Al-Madi EM. Managing Cardiac Patients: Dentists' Knowledge, Perceptions, and Practices. Int Dent J 2021; 72:296-307. [PMID: 34256924 PMCID: PMC9275076 DOI: 10.1016/j.identj.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Dental patients may require invasive treatment, and awareness of their medical conditions is essential for optimal care. We assessed the knowledge, perceptions, and attitudes of dentists practicing in Saudi Arabia (SA) and their associations with managing patients with common cardiac conditions. METHODS A national survey of knowledge and attitudes of practicing dentists towards patients with common cardiac conditions was conducted from May 2019 to July 2020 in SA. The survey comprised a newly developed, validated, electronic, self-administered English questionnaire. RESULTS Overall, 282 dentists completed the survey, of whom 45.5% perceived cardiac patients as difficult to manage, while 64.5% stated that they refer these patients to cardiologists before dental intervention. Regarding knowledge about cardiac conditions, 72% achieved an overall knowledge score <55%; however, their infective endocarditis scores were better. Consultants and specialists (P < .001), those with a PhD/board certification (P = .013), dentists with prior education on cardiac patient management (P = .002), and those working with a cardiologist (P = .016) scored higher on knowledge. Conversely, private dentists (P = .003) and those referring patients to cardiologists before treatment (P = .003) scored lower. Dentists' knowledge of cardiovascular diseases in women was low; only those who believed women experience a greater risk of cardiac complications achieved a higher score. Approximately 90.1% wished to receive education regarding cardiac patient management. CONCLUSIONS Knowledge of cardiac patient management was suboptimal in this study. Dentists perceived cardiac patients as difficult to manage, but wished to learn more regarding optimal management. Thus, postgraduate education programmes that promote optimal dental management strategies for cardiac patients are necessary.
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Affiliation(s)
- Maha A Al-Mohaissen
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Rabah Al-Mehisen
- Department of Cardiology, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Terry Lee
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Ebtissam M Al-Madi
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Aragoneses J, Suárez A, Rodríguez C, Algar J, Aragoneses JM. Knowledge, Attitudes, and Practices among Dental Practitioners Regarding Antibiotic Prescriptions for Pregnant and Breastfeeding Women in the Dominican Republic. Antibiotics (Basel) 2021; 10:668. [PMID: 34205115 PMCID: PMC8229999 DOI: 10.3390/antibiotics10060668] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/20/2021] [Accepted: 06/02/2021] [Indexed: 02/05/2023] Open
Abstract
In this study, we aimed to explore the trends among dentists in the Dominican Republic of providing antibiotic prescriptions to pregnant/breastfeeding dental patients. A survey was conducted among 98 dentists, using a self-administered questionnaire, about their knowledge and attitudes regarding antibiotic usage in pregnant/lactating women and the translation of these into practice. The majority of the survey population were female dentists (63.3%) aged 45-54 years. A chi-square test showed statistically significant differences in the knowledge sources between older and younger dentists, with a minority having chosen scientific literature as a source (p-value of 0.04). There were statistically significant associations between gender and certain attitudes and practice-based questions, with p-values of 0.04 and 0.01, respectively. The Spearman's correlation test showed a statistically significant correlation between knowledge and attitude (p-value 0.001), whereas no correlation was found with practice (p-value 0.23). A multiple response analysis showed that the majority of the respondents chose the second and third trimester for antibiotic prescriptions for acute conditions such as cellulitis, periodontal abscess, and pericoronitis. Most dentists had sufficient knowledge about antibiotic usage in pregnant/lactating women, but it did not translate into practice, and a certain proportion of the participants followed incongruent drug prescription. These findings can be used to focus on judicious antibiotic usage by dentists in the Dominican Republic.
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Affiliation(s)
- Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, University of Alcalá, 28801 Madrid, Spain;
| | - Ana Suárez
- Department of Preclinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henriquez y Carvajal, 10106 Santo Domingo, Dominican Republic;
| | - Juan Algar
- Department of Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, 28005 Madrid, Spain;
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Hleyhel M, Haddad C, Haidar N, Charbachy M, Saleh N. Determinants of knowledge and prevention measures towards COVID-19 pandemic among Lebanese dentists: a cross sectional survey. BMC Oral Health 2021; 21:241. [PMID: 33957922 PMCID: PMC8100939 DOI: 10.1186/s12903-021-01599-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) is a major global threat. Healthcare professionals including dentists are facing real challenges during this pandemic. This study aimed to evaluate knowledge, attitudes, and prevention measures of Lebanese dentists towards COVID-19 and determinants of high level of knowledge and prevention practices. METHODS A cross-sectional study was conducted between May and August 2020 in Lebanon on a random sample of 323 Lebanese dentists. Data were collected through an online survey questionnaire. A multivariate linear regression model was used to evaluate factors associated with COVID-19 knowledge. A multivariate logistic regression was conducted to evaluate the factors associated with high level of prevention measures towards COVID-19. RESULTS The mean COVID-19 knowledge index was 24.5 over 38 with only 15% achieving high knowledge level. The mean prevention measures index was 11.4 over 16 with only 35% achieving high prevention level. Higher knowledge index was associated with younger age, being employed, and considering dentist's role significant in teaching others about COVID-19. General dental practitioners, dentists living with family members and concerned about their family members to get infected because of their occupational exposure were more likely to report higher level of adopted prevention measures. Higher knowledge was associated with high level of prevention measures. CONCLUSIONS Given the rapid evolution of information related to COVID-19 pandemic, dentists should be regularly educated through trainings, workshops, and updates of national guidelines for dental healthcare.
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Affiliation(s)
- Mira Hleyhel
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health II, Lebanese University, Fanar, Lebanon. .,INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique Et Toxicologie - Liban, Beirut, Lebanon. .,Faculty of Public Health, Lebanese University, Fanar, Lebanon.
| | | | - Nour Haidar
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Maria Charbachy
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Nadine Saleh
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health II, Lebanese University, Fanar, Lebanon.,INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique Et Toxicologie - Liban, Beirut, Lebanon.,Faculty of Public Health, Lebanese University, Fanar, Lebanon
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Hajj A, Azzo C, Hallit S, Salameh P, Sacre H, Abdou F, Naaman N, Khabbaz LR. Assessment of drug-prescribing perception and practice among dental care providers: a cross-sectional Lebanese study. Pharm Pract (Granada) 2021; 19:2234. [PMID: 33777263 PMCID: PMC7979316 DOI: 10.18549/pharmpract.2021.1.2234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 02/28/2021] [Indexed: 12/04/2022] Open
Abstract
Background: Dentists play an essential role in providing high-quality dental care, taking
into consideration the clinical context and concomitant medications taken by
the patients. Objective: This study aimed to assess drug-prescribing perception and practices in
addition to drug-related educational needs among Lebanese dentists; it also
evaluated the need for interprofessional collaboration between dentists and
pharmacists. Methods: An exploratory cross-sectional study using an online questionnaire targeted a
sample of dentists from all Lebanese districts. Participants gave their
consent by accepting to complete the survey (ethics approval reference:
USJ-2016-63). The questionnaire consisted of closed-ended questions
exploring: 1) drug-prescribing perception, 2) drug-prescribing practice, and
3) collaboration with pharmacists regarding their respective roles in
providing appropriate counseling to patients. Two indexes were created: the
first evaluated self-confidence in prescribing medications, and the second
assessed dentists’ confidence in pharmacists. Logistic regressions
were performed, taking each index as a dependent variable. Results A total of 137 dentists completed the survey (59% females; mean age:
42.17; SD: 13.78 years). The majority had a fair to good perceived knowledge
in pharmacology and therapeutics (80.3%), only 30.7% reported
to be sufficiently equipped to prescribe safely. Dentists exhibited
particularly low perceived knowledge about prescribing in elderly patients,
dosing, medication use in pregnancy, drug interactions, and adverse
reactions. Dentists specialized in periodontics had the lowest odds of
having self-confidence in prescribing drugs (aOR=0.25; p<0.001).
Also, 64.3% declared that they routinely check a reference source
before prescribing, and 78% relied on pharmaceutical companies and
medical representatives to get information on medications. While 61%
declared that pharmacists should provide oral care counseling, only half of
them encouraged their patients to talk to their pharmacists about their
medications. Only 15% considered that patients are getting enough
counseling from the pharmacist, with a global confidence index below the
median value, suggesting the need for more collaboration, especially with
periodontists who exhibited the lowest confidence in pharmacists
(aOR=0.45). Conclusions Lebanese dentists reported some lack of knowledge and confidence in
prescribing practices. Education, training, and close collaboration between
pharmacists and dentists are essential to overcome these problems and avoid
potential harm to patients.
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Affiliation(s)
- Aline Hajj
- PharmD, PhD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
| | - Christel Azzo
- PharmD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
| | - Souheil Hallit
- PharmD, PhD. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK) . Jounieh ( Lebanon ).
| | - Pascale Salameh
- PharmD, PhD. School of Medicine, University of Nicosia . Nicosia ( Cyprus ).
| | - Hala Sacre
- PharmD. National Institute of Public Health, Clinical Epidemiology, and Toxicology-Lebanon (INSPECT-LB) . Beirut ( Lebanon ).
| | - Frederic Abdou
- PharmD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
| | - Nada Naaman
- DDS, PhD. Faculty of Dental medicine, Saint-Joseph University . Beirut ( Lebanon ).
| | - Lydia R Khabbaz
- PharmD, PhD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
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Torres NF, Solomon VP, Middleton LE. Pharmacists' practices for non-prescribed antibiotic dispensing in Mozambique. Pharm Pract (Granada) 2020; 18:1965. [PMID: 32922571 PMCID: PMC7470239 DOI: 10.18549/pharmpract.2020.3.1965] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background Antibiotics are the most frequently used medicines worldwide with most of the countries defining these as prescription-only medicines. Though, dispensing non-prescribed antibiotics represent one of the chief causal factors to the irrational use of antibiotics that paves the way to the development of antimicrobial resistance. Objective We aimed at describing the practices and the enablers for non-prescribed antibiotic dispensing in Maputo city, Mozambique. Methods A qualitative study was conducted, between October 2018 and March 2019, in nine private pharmacies randomly selected across Maputo city. Eighteen pharmacists were contacted and seventeen enrolled through snowball sampling. In-depth interviews were conducted, audiotaped, and transcribed verbatim. Transcripts were coded and analysed though thematic analysis with guidelines from Braun and Clark. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist by (Tong, 2007) was performed. Results Out of seventeen, fifteen pharmacists admitted non-prescribed dispensing of antibiotics. Common antibiotic dispensing practices included; dispensing without prescription, without asking for a brief clinical history of patients, without clear explanation of the appropriate way of administering, without advising on the side effects. Reasons for non-prescribed antibiotic dispensing are linked to patients' behaviour of demanding for non-prescribed antibiotics, to the patients expectations and beliefs on the healing power of antibiotics, to the physicians' prescribing practices. Other reasons included the pressure for profits from the pharmacy owners, the fragile law enforcement, and absence of accountability mechanisms. Conclusions The practices of non-prescribed antibiotic dispensing characterize the 'daily life' of the pharmacists. On the one hand, the patient's demand for antibiotics without valid prescriptions, and pharmacist's wish to assist based on their role in the pharmacy, the pressure for profits and on the understanding of the larger forces driving the practices of self-medication with antibiotics - rock. On the other hand, pharmacists are aware of the legal status of antibiotics and the public health consequences of their inappropriate dispensing practices and their professional and ethical responsibility for upholding the law - hard place. Highlighting the role of pharmacists and their skills as health promotion professionals is needed to optimizing antibiotic dispensing and better conservancy in Mozambique.
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Affiliation(s)
- Neusa F Torres
- Higher Institute for Health Sciences (ISCISA). Maputo (Mozambique).
| | - Vernon P Solomon
- MSc (Clin Psychol). Discipline of Pharmaceutical Sciences School of Health Sciences, University of KwaZulu Natal. Durban (South Africa).
| | - Lyn E Middleton
- Phd (Nurs & Educ). Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu Natal. Durban (South Africa).
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