The Periodontal Research Group, School of Dentistry University of Birmingham, 5 Mill Pool Way, Birmingham, B5 7EG, UK.
School of Pharmacy, University of Birmingham, Birmingham, UK.
BMC Public Health. 2020 Oct 20;20(1):1576. doi: 10.1186/s12889-020-09649-7.
Non-communicable diseases [NCDs] are the major cause of mortality globally and are increasing in prevalence. Different healthcare professionals' access different population groups; and engaging allied healthcare professionals in risk-driven early case detection of certain NCDs may be beneficial, especially those who have not been tested for NCDs within the previous 12 months. The objectives of this study were to determine: whether NCD case finding in dental/community pharmacy settings is feasible in terms of patient acceptability, barriers to recruitment, impact on the existing service. Determine time taken to test for: type 2 diabetes risk [T2DM], chronic obstructive pulmonary disease [COPD], hypertension, vitamin D deficiency and chronic kidney disease [CKD]. Determine whether there is added benefit of point of care testing [POCT] to identify diabetes risk compared to a validated screening questionnaire alone.
An exploratory study was undertaken to explore issues associated with NCD assessment in one dental practice and one community pharmacy within the West-Midlands, UK. Fifty patients > 40 years-of-age were recruited per site. Participants undertook: a questionnaire providing demographic data, any previous NCD diagnosis or positive family history. Validated questionnaires for determining NCD risk [T2DM/COPD]. Chair-side capillary blood [finger-prick] samples for HbA1C, creatinine/eGFR, Vitamin-D. Prior work had been undertaken to measure the agreement between point of care testing [POCT] devices and a central laboratory method, and to gauge the opinions of participants regarding discomfort experienced using venous (antecubital fossa) and capillary (finger-prick) blood collection, via a 10 cm Visual-Analogue-Scale. The POCT devices demonstrated good concordance with laboratory testing and were acceptable methods of blood collection for participants.
Recruitment rates demonstrated that 8 days were needed to recruit 50 participants and 60% of those approached opted to participate. The principal barrier to participation was time, with average time taken to test being 19mins. Utilising dental and pharmacy settings identified potential cases of previously undiagnosed disease.
Risk-targeted testing for NCDs in high street dental and community pharmacies is both attractive and acceptable to patients.
非传染性疾病（NCDs）是全球主要的死亡原因，其患病率正在上升。不同的医疗保健专业人员接触不同的人群；让辅助医疗保健专业人员参与某些 NCD 的风险驱动的早期病例发现可能是有益的，特别是那些在过去 12 个月内没有接受过 NCD 检测的人。本研究的目的是确定：在患者可接受性、招募障碍、对现有服务的影响方面，在牙科/社区药房环境中进行 NCD 病例发现是否可行。确定测试以下疾病的时间：2 型糖尿病风险[T2DM]、慢性阻塞性肺疾病[COPD]、高血压、维生素 D 缺乏症和慢性肾脏病[CKD]。确定与单独使用经过验证的筛选问卷相比，在护理点进行检测[POCT]是否可以更有效地识别糖尿病风险。
在英国西米德兰兹的一家牙科诊所和一家社区药房进行了一项探索性研究，以探讨与 NCD 评估相关的问题。每个地点招募了 50 名年龄大于 40 岁的患者。参与者接受了：一份调查问卷，提供人口统计学数据、任何先前的 NCD 诊断或阳性家族史。用于确定 NCD 风险[T2DM/COPD]的经过验证的问卷。椅旁毛细血管血[指尖]样本用于测定 HbA1C、肌酐/eGFR、维生素-D。先前的工作已经完成，以测量护理点检测[POCT]设备与中央实验室方法之间的一致性，并通过 10cm 视觉模拟量表衡量参与者对使用静脉（肘窝）和毛细血管（指尖）采血时感到不适的意见。POCT 设备与实验室检测具有良好的一致性，并且是参与者可接受的采血方法。
招募率表明，招募 50 名参与者需要 8 天时间，而被接触的参与者中有 60%选择参与。参与的主要障碍是时间，平均测试时间为 19 分钟。利用牙科和药房环境确定了以前未确诊疾病的潜在病例。
在高街牙科和社区药房进行 NCD 风险靶向检测对患者具有吸引力和可接受性。
