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牙科专业人员在管理服用抗凝药和抗血小板药物患者方面的做法和信念。

The practices and beliefs of dental professionals regarding the management of patients taking anticoagulant and antiplatelet drugs.

作者信息

Kelly Niamh, Beaton Laura, Knights Jennifer, Stirling Douglas, West Michele, Young Linda

机构信息

Dental Core Trainee, Dundee Dental Hospital and School, NHS Tayside, Dundee, UK.

NHS Education for Scotland, Scotland, UK.

出版信息

BDJ Open. 2023 Jan 25;9(1):1. doi: 10.1038/s41405-022-00127-3.

Abstract

AIM

This study aimed to inform the implementation of the updated Scottish Dental Clinical Effectiveness Programme (SDCEP) guidance, 'Management of Dental Patients taking Anticoagulant or Antiplatelet Drugs', and to determine training needs by investigating dental professionals' current practice and beliefs regarding management of patients taking these medications.

METHODS

Dental professionals were recruited via the NHS Education for Scotland Portal. The online questionnaire collected demographic information, data on current practice and information about beliefs regarding behaviours related to the management of patients on anticoagulant or antiplatelet medication. Quantitative data were analysed using SPSS and subjected to frequency calculations, t-tests, one-way ANOVA and linear regression. Qualitative data were collected via free text boxes and analysed using thematic analysis.

RESULTS

One hundred and fifty-seven participants responded to the questionnaire. The majority of respondents stated they were aware of the guidance and always based their practice on it. The majority of respondents always assessed the patient's individual bleeding risk prior to dental procedures. Most respondents felt that they did not know how to appropriately manage patients taking low doses of low molecular weight heparins (LMWH), and only 38% of respondents always followed SDCEP guidance about direct oral anticoagulants (DOAC) medication and procedures with a low associated risk of bleeding.

DISCUSSION

This study demonstrates a need for further educational support surrounding LMWHs and management of patients on DOAC medication. Time and remuneration represent barriers to guidance implementation in primary care.

CONCLUSION

There is good awareness and adherence to the guidance in primary care settings, however training needs were identified to support implementation.

摘要

目的

本研究旨在为更新后的苏格兰牙科临床疗效计划(SDCEP)指南《服用抗凝剂或抗血小板药物的牙科患者管理》的实施提供信息,并通过调查牙科专业人员对服用这些药物患者管理的当前实践和信念来确定培训需求。

方法

通过苏格兰国民保健服务教育门户网站招募牙科专业人员。在线问卷收集了人口统计学信息、当前实践数据以及关于与服用抗凝剂或抗血小板药物患者管理相关行为的信念信息。使用SPSS对定量数据进行分析,并进行频率计算、t检验、单因素方差分析和线性回归。定性数据通过自由文本框收集,并使用主题分析进行分析。

结果

157名参与者回复了问卷。大多数受访者表示他们知晓该指南,并始终依据其开展实践。大多数受访者在牙科手术前总是会评估患者的个体出血风险。大多数受访者认为他们不知道如何妥善管理服用低剂量低分子肝素(LMWH)的患者,并且只有38%的受访者始终遵循SDCEP关于直接口服抗凝剂(DOAC)药物及出血风险较低的手术的指南。

讨论

本研究表明在LMWH以及DOAC药物治疗患者的管理方面需要进一步的教育支持。时间和报酬是初级保健中指南实施的障碍。

结论

在初级保健环境中对该指南有良好的认知和遵循情况,然而已确定需要培训以支持实施。

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