Evaluating the impact of caries prevention and management by caries risk assessment guidelines on clinical practice in a dental teaching hospital

BMC Oral Health

Research Article

Cynthia K. Y. Yiu¹  Gillian H. M. Lee¹  Colman McGrath² 

[1] Paediatric Dentistry & Orthodontics, Faculty of Dentistry, University of Hong Kong, 2/F, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China;Periodontology and Public Health, Faculty of Dentistry, University of Hong Kong, 3/F, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China;

关键词: Guidelines;    Guidelines implementation;    Evaluation;    Oral health;    Children;    Caries risk assessment;    Dental caries;    Prevention;    ADAPTE;    Delphi consensus;   

DOI  :  10.1186/s12903-016-0217-9

 received in 2015-09-04, accepted in 2016-05-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundClinical practice guidelines on ‘Dental caries prevention and management by caries risk assessment for pre-school children in Hong Kong’ were developed using ADAPTE process and Delphi consensus technique. This study aimed to evaluate the feasibility of disseminating and implementing the guidelines, and to evaluate their effectiveness in changing clinical practice.MethodsThe study was conducted in two phases, examining clinical records of pre-school aged patients being treated by non-academic clinical staff in the Paediatric Dentistry Clinic of a dental teaching hospital in Hong Kong. The clinical guidelines were introduced to the staff in a departmental seminar at the end of pre-intervention phase. Post-intervention phase began one month after the introduction of guidelines. Clinical records for three consecutive months were reviewed against standards and recommendations derived from the newly developed clinical guidelines in both phases. The results were assessed by Chi-square test, ANOVA and regression analyses.ResultsA total of 237 and 147 clinical records were reviewed in pre-intervention and post-intervention phases, respectively. Guideline adherence percentage increased significantly on almost all aspects of the guidelines in the post-intervention phase (P < 0.05). There were a significant difference in the mean overall guideline adherence score (pre-intervention phase: x¯\documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$ \overline{\mathrm{x}} $$\end{document} = 14.86 ± 6.11; post-intervention phase: x¯\documentclass[12pt]{minimal}\usepackage{amsmath}\usepackage{wasysym}\usepackage{amsfonts}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{mathrsfs}\usepackage{upgreek}\setlength{\oddsidemargin}{-69pt}\begin{document}$$ \overline{\mathrm{x}} $$\end{document} = 28.88 ± 8.75) and sub-domain adherence scores between the two phases (P < 0.001). The training grade of the clinicians was the factor associated with changes in evidence-based practice (P < 0.001).ConclusionsThe developed guidelines were effective in translating evidence into best practice. The findings have implication for widespread implementation.

【 授权许可】

CC BY   
© The Author(s). 2016

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