School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia.
Centre for Optimising Pharmacy Practice-based Excellence in Research, The University of Queensland, Brisbane, Queensland, Australia.
Community Dent Oral Epidemiol. 2019 Jun;47(3):225-235. doi: 10.1111/cdoe.12448. Epub 2019 Feb 8.
In Australia, more than 80% of pharmacists and pharmacy assistants are consulted for oral healthcare advice up to five times or more each week. This study assesses Australian community pharmacy staff's (pharmacists and pharmacy assistants) ability to recognize and manage common oral health presentations using case vignettes, and determine whether appropriate identification and management are associated with self-reported confidence.
Five oral healthcare case vignettes were developed based on previous literature by a multidisciplinary team of dental and pharmacy practitioner academics. Topics included pulpitis, gingivitis, oral hygiene advice for a toddler, a mouth ulcer and a dry mouth scenario. Pharmacies were randomly selected from each Australian State and Territory and community pharmacy staff invited to complete the case vignettes.
A total of 312 and 932 case vignettes were completed by pharmacy assistants and pharmacists, respectively. Approximately one-third of staff appropriately identified a non-healing mouth ulcer and up to 16% recognized a pulpitis (inflamed dental pulp) presentation. Provision of best practice or evidence-based recommendations were reported in up to 28%, 19%, 57% and 31% of pharmacy staff offering appropriate advice and guidance for pulpitis, gingivitis, a non-healing mouth ulcer and oral health promotion messages, respectively. No participants provided all best practice recommendations for drug-induced xerostomia. In all five vignettes, confidence was not associated with best practice recommendations and was only modestly associated with improved rates for recognizing gingivitis symptoms.
To allow community pharmacists and assistants to fulfil their role as important members of the oral healthcare team, additional training and support are required to facilitate improved recognition of common oral health presentations and to offer recommendations which are in line with current best practice guidelines.
在澳大利亚，超过 80%的药剂师和药房助理每周都会被咨询多达五次或更多次的口腔保健建议。本研究通过案例情景评估澳大利亚社区药房工作人员（药剂师和药房助理）识别和管理常见口腔健康问题的能力，并确定是否适当的识别和管理与自我报告的信心相关。
由口腔医学和药学从业者组成的多学科团队根据以往文献开发了五个口腔保健案例情景。主题包括牙髓炎、牙龈炎、幼儿口腔卫生建议、口腔溃疡和口干场景。从澳大利亚每个州和地区随机选择药店，并邀请社区药房工作人员完成案例情景。
共有 312 名药房助理和 932 名药剂师完成了案例情景。约三分之一的工作人员正确识别出未愈合的口腔溃疡，多达 16%的工作人员识别出牙髓炎（发炎的牙髓）表现。在提供牙髓炎、牙龈炎、未愈合的口腔溃疡和口腔健康促进信息的最佳实践或循证建议方面，高达 28%、19%、57%和 31%的药房工作人员报告了适当的建议和指导。没有参与者为药物引起的口干提供所有最佳实践建议。在所有五个案例情景中，信心与最佳实践建议无关，仅与识别牙龈炎症状的改善率略有相关。
为了使社区药剂师和助理能够发挥其作为口腔保健团队重要成员的作用，需要额外的培训和支持，以促进对常见口腔健康问题的更好识别，并提供符合当前最佳实践指南的建议。
