TY - JOUR
T1 - Implementation of an oral care protocol for primary diabetes care
T2 - A pilot cluster-randomized controlled trial
AU - Verhulst, M.J.L.
AU - Teeuw, W.J.
AU - Gerdes, V.E.A.
AU - Loos, B.G.
N1 - Funding Information: In addition, author Bruno G. Loos was supported in part by a grant from the University of Amsterdam for the focal point of oral infection and inflammation. Publisher Copyright: © 2021, Annals of Family Medicine, Inc. All rights reserved.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - © 2021, Annals of Family Medicine, Inc. All rights reserved.PURPOSE Although diabetes care guidelines recommend paying attention to oral health, the effect on daily practice has been limited, and patients with diabetes have yet to benefit. We investigated whether implementation of an oral care protocol for general practitioners (GPs [family physicians]) can improve patient-centered outcomes for patients with type 2 diabetes. METHODS Twenty-four GP offices were randomly assigned to the experimental or control group (12 offices each). In the experimental group, GPs and nurse practitioners implemented an oral care protocol. No extra attention was given to oral health in the control group. The primary outcome parameter was oral health–related quality of life (QoL) assessed with the 14-item Oral Health Impact Profile at baseline and 1 year later. Other outcomes were self-reported oral health complaints and general health–related QoL (36-item Short Form Health Survey). RESULTS Of 764 patients with type 2 diabetes, 543 (71.1%) completed the 1-year follow-up. More patients reported improved oral health–related QoL in the experimental group (35.2%) compared to the control group (25.9%) (P = .046; Padj = .049). In a secondary post hoc analysis including GP offices with ≥60% patient follow-up (n = 18), improvement was 38.3% and 24.9%, respec-tively (P and Padj = .011). Improvement of self-reported oral health complaints did not differ between groups. The intervention had no effect on general health– related QoL, with the exception of the concept scale score for changes in health over time (Padj = .033). CONCLUSIONS Implementation of an oral care protocol in primary diabetes care improved oral health–related QoL in patients with type 2 diabetes.
AB - © 2021, Annals of Family Medicine, Inc. All rights reserved.PURPOSE Although diabetes care guidelines recommend paying attention to oral health, the effect on daily practice has been limited, and patients with diabetes have yet to benefit. We investigated whether implementation of an oral care protocol for general practitioners (GPs [family physicians]) can improve patient-centered outcomes for patients with type 2 diabetes. METHODS Twenty-four GP offices were randomly assigned to the experimental or control group (12 offices each). In the experimental group, GPs and nurse practitioners implemented an oral care protocol. No extra attention was given to oral health in the control group. The primary outcome parameter was oral health–related quality of life (QoL) assessed with the 14-item Oral Health Impact Profile at baseline and 1 year later. Other outcomes were self-reported oral health complaints and general health–related QoL (36-item Short Form Health Survey). RESULTS Of 764 patients with type 2 diabetes, 543 (71.1%) completed the 1-year follow-up. More patients reported improved oral health–related QoL in the experimental group (35.2%) compared to the control group (25.9%) (P = .046; Padj = .049). In a secondary post hoc analysis including GP offices with ≥60% patient follow-up (n = 18), improvement was 38.3% and 24.9%, respec-tively (P and Padj = .011). Improvement of self-reported oral health complaints did not differ between groups. The intervention had no effect on general health– related QoL, with the exception of the concept scale score for changes in health over time (Padj = .033). CONCLUSIONS Implementation of an oral care protocol in primary diabetes care improved oral health–related QoL in patients with type 2 diabetes.
KW - Oral care
KW - Oral health
KW - Primary care
KW - Quality of life
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=85107478906&partnerID=8YFLogxK
U2 - https://doi.org/10.1370/afm.2645
DO - https://doi.org/10.1370/afm.2645
M3 - Article
C2 - 34180838
SN - 1544-1709
VL - 19
SP - 197
EP - 206
JO - Annals of family medicine
JF - Annals of family medicine
IS - 3
ER -