Document Detail


A randomised controlled trial of clinical outreach education to rationalise antibiotic prescribing for acute dental pain in the primary care setting.
MedLine Citation:
PMID:  16902573     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the effect of educational outreach visits on antibiotic prescribing for acute dental pain in primary care. STUDY DESIGN: RCT. SETTING: General dental practices in four health authority areas in Wales. SUBJECTS AND METHODS: General dental practitioners were recruited to the study and randomly allocated to one of the three study groups (control group, guideline group or intervention group). Following the intervention, practitioners completed a standardised questionnaire for each patient that presented with acute dental pain. INTERVENTIONS: The control group received no intervention. The guideline group received educational material by post. The intervention group received educational material by post and an academic detailing visit by a trained pharmacist. The educational material included evidence-based guidelines on prescribing for acute dental pain and patient information leaflets. MAIN OUTCOME MEASURES: The number of antibiotic prescriptions issued to patients presenting with dental pain and the number of 'inappropriate' antibiotic prescriptions. Antibiotics were considered to be inappropriate if the patient did not have symptoms indicative of spreading infection. RESULTS: A total of 1,497 completed questionnaires were received from 23, 20 and 27 general dental practitioners in the control, guideline and intervention group respectively. Patients in the intervention group received significantly fewer antibiotic prescriptions than patients in the control group (OR (95% CI) 0.63 (0.41, 0.95)) and significantly fewer inappropriate antibiotic prescriptions (OR (95% CI) 0.33 (0.21, 0.54)). However, antibiotic and inappropriate antibiotic prescribing were not significantly different in the guideline group compared to the control group (OR (95% CI) 0.83 (0.55, 1.21) and OR (95% CI) 0.82 (0.53, 1.29) respectively). CONCLUSIONS: Strategies based upon educational outreach visits may be successfully employed to rationalise antibiotic prescribing by dental practitioners.
Authors:
J M Seager; R S Howell-Jones; F D Dunstan; M A O Lewis; S Richmond; D W Thomas
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British dental journal     Volume:  201     ISSN:  0007-0610     ISO Abbreviation:  Br Dent J     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-11     Completed Date:  2007-02-12     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  7513219     Medline TA:  Br Dent J     Country:  England    
Other Details:
Languages:  eng     Pagination:  217-22; discussion 216     Citation Subset:  D; IM    
Affiliation:
Department of Oral Surgery, Medicine and Pathology, Wales College of Medicine, Cardiff University, Cardiff, CF14 4XY.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / therapeutic use*
Dentist's Practice Patterns*
Education, Dental, Continuing / methods*
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Practice Guidelines as Topic*
Toothache / drug therapy*
Wales
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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