A Link Work Intervention to Facilitate Dental Visiting in People With Severe Mental Illness: A Two-Arm, Multi-Site, Assessor Blind, Randomised Feasibility Trial With Dental Record Linkage
Jasper Palmier-Claus, Abigail Morris, Paul French, Robert Griffiths, Vishal R. Aggarwal, Katherine Berry, Efstathia Gkioni, Rebecca Harris, Louise Laverty, Fiona Lobban, Sarah Procter, Eirian Kerry, Connie Newens, Pauline Mupinga, Rebecca Golby, Kyriakos Valemis, Lucy Oakes, Fanni Fazekas, Antonia Perry, David Shiers, Christopher Lodge, Claire Hilton, Alison Dawber, Emma Elliott, Farah Lunat, Girvan Burnside
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引用次数: 0
Abstract
Objectives
People with severe mental illness experience poor oral health, compared to the general population. They experience inequity in accessing dental services. This randomised controlled trial evaluated the acceptability and feasibility of a link work intervention to support people with severe mental illness to access a routine dental appointment.
Methods
This was a feasibility randomised controlled trial across three sites with 1:1 allocation to Treatment as usual (TAU) or TAU plus a link work intervention (ISRCTN13650779). Participants were adults accessing mental health services who had not attended a routine dental appointment in the past 3 years. The intervention comprised up to six sessions with a link worker. Participants completed self-report assessments and an optional dental examination at baseline and after nine months. Dental visiting data were obtained through self-report and the NHS Business Services Authority (BSA).
Results
One hundred and sixty-one participants were referred into the trial, resulting in 79 out of the target 84 randomisations (94.0%) over 7 months. There were high levels of engagement with the intervention. Dental visiting data were available for 84.8% of participants (95% CI: 75.3%, 91.1%). Uptake of the optional dental examination within the research assessment battery was low (follow-up: 12.7%; 95% CI: 7.0%, 21.8%). There were no serious adverse events attributable to the intervention or trial procedures. There were substantially higher rates of dental attendance after nine months in the link work intervention arm, compared to TAU, in both the self-report (91.7% vs. 26.7%) and NHS BSA (55.3% vs. 12.1%) data. There was also a signal of improved self-reported oral health-related quality of life favouring the link work intervention arm.
Conclusions
The trial procedures and link work intervention were found to be feasible, acceptable and safe. The intervention showed promise in terms of clinical outcomes. The effectiveness of the intervention requires evaluation in a larger trial.
期刊介绍：
The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome.
The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry.
The journal is published bimonthly.
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