School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
National University Centre for Oral Health, National University of Singapore, Singapore.
Prim Care Diabetes. 2020 Apr;14(2):126-132. doi: 10.1016/j.pcd.2019.11.010. Epub 2019 Dec 9.
To explore inter-professional communication and collaboration in guideline-concordant diabetes and periodontitis care.
Qualitative design using iterations of workshops to identify ways to improve multidisciplinary working attended by staff from medical and dental primary care practices, and people with diabetes (n=43). Workshops were semi-structured around a topic guide. Recruitment was via the UK Clinical Research Network, and a patient and public involvement group in the North of England.
Medical practice participants were unaware of the bidirectional evidence linking diabetes and periodontitis and stated that they had never received a referral from a dental professional in this context. The patient participants with diabetes reported never having been informed about the links between diabetes and periodontitis from either their family physician or dentist. Medical and dental practice participants gave negative accounts of inter-professional communication, with claims of inappropriate requests and defensive or non-responses that stymied future interaction. Indirect communication through the patient was suggested as an alternative to direct communication.
Indirect referral, whereby the patient is signposted to a healthcare professional, was suggested by medical and dental professionals as a useful alternative to the traditional (and time consuming) letter or telephone call, particularly in the case of suspected diabetes or periodontitis.
探讨符合指南的糖尿病和牙周炎护理中的跨专业沟通与协作。
采用迭代工作坊的定性设计,以确定改善多学科工作的方法,参与者来自医疗和牙科初级保健实践以及糖尿病患者(n=43)的工作人员。工作坊围绕主题指南进行半结构化。招募是通过英国临床研究网络和英格兰北部的患者和公众参与小组进行的。
医疗实践参与者不知道糖尿病和牙周炎之间的双向证据,并且表示他们从未在这种情况下收到过来自牙科专业人员的转介。患有糖尿病的患者参与者表示,他们从未从家庭医生或牙医那里被告知糖尿病和牙周炎之间的联系。医疗和牙科实践参与者对跨专业沟通的评价不佳,声称收到了不适当的请求,或者做出防御性或非回应,从而阻碍了未来的互动。通过患者进行间接沟通被认为是直接沟通的替代方式。
医疗和牙科专业人员建议,间接转诊,即通过患者转介到医疗保健专业人员,是传统(且耗时)信件或电话转介的有用替代方案,特别是在疑似糖尿病或牙周炎的情况下。