Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.
Ann Fam Med. 2021 May-Jun;19(3):197-206. doi: 10.1370/afm.2645. Epub 2021 May 10.
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.
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).
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%) ( = .046; = .049). In a secondary post hoc analysis including GP offices with ≥60% patient follow-up (n = 18), improvement was 38.3% and 24.9%, respectively ( and = .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 ( = .033).
Implementation of an oral care protocol in primary diabetes care improved oral health-related QoL in patients with type 2 diabetes.
尽管糖尿病护理指南建议关注口腔健康，但这对日常实践的影响有限，糖尿病患者尚未从中受益。我们研究了在全科医生（家庭医生）中实施口腔护理方案是否可以改善 2 型糖尿病患者以患者为中心的结局。
24 家全科医生办公室被随机分配到实验组或对照组（每组 12 家）。在实验组中，全科医生和执业护士实施了口腔护理方案。对照组没有额外关注口腔健康。主要结局参数是使用 14 项口腔健康影响量表在基线和 1 年后评估的口腔健康相关生活质量（QoL）。其他结局是自我报告的口腔健康投诉和一般健康相关 QoL（36 项简短健康调查问卷）。
在 764 名 2 型糖尿病患者中，有 543 名（71.1%）完成了 1 年随访。实验组（35.2%）报告口腔健康相关 QoL 改善的患者多于对照组（25.9%）（ =.046； =.049）。在包括有≥60%患者随访的 GP 办公室的二次事后分析中（n = 18），改善率分别为 38.3%和 24.9%（和 =.011）。两组之间自我报告的口腔健康投诉的改善没有差异。该干预措施对一般健康相关 QoL 没有影响，除了健康随时间变化的概念量表评分（ =.033）。
在初级糖尿病护理中实施口腔护理方案可改善 2 型糖尿病患者的口腔健康相关 QoL。
