需要居家护理的门诊患者的系统疾病与口腔健康的相互作用（InSEMaP）：德国牙科和全科医疗护理部门边界的观察性研究。

Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP): an observational study at the sector boundary between dental and general practice care in Germany.

机构信息

Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany

Department of Nursing and Management, Cooperative Process Management in Social and Healthcare RTC (KoPM-Zentrum), Hamburg University of Applied Sciences; Faculty of Business and Social Sciences, Hamburg, Germany.

出版信息

BMJ Open. 2023 Mar 13;13(3):e063685. doi: 10.1136/bmjopen-2022-063685.

DOI:10.1136/bmjopen-2022-063685

PMID:36914197

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10016254/

Abstract

INTRODUCTION

Older people in need of home care are at risk of declining oral health as their visits to dentists are becoming less frequent due to restricted mobility. There is increasing evidence that poor oral health and systemic diseases are closely associated, for example, in cardiological, metabolic or neurodegenerative conditions. Thus, Interaction of Systemic Morbidity and Oral Health in Ambulatory Patients in Need of Home Care (InSEMaP) is investigating the need, provision and utilisation of oral healthcare, systemic morbidity and clinical status of the oral cavity in older people.

METHODS AND ANALYSIS

InSEMaP consists of four subprojects (SP), all involving the target population of older people in need of home care. In SP1 part a, a sample is surveyed using a self-report questionnaire. In SP1 part b, stakeholders (general practitioners, dentists, medical assistants, family and professional caregivers) are interviewed regarding barriers and facilitators using focus groups and personal interviews. In SP2, a retrospective cohort study, health insurance claims data are examined to investigate the utilisation of oral healthcare, its association with systemic morbidity and healthcare costs. In SP3, a clinical observational study will assess the oral health of participants by a dentist's visit at home. SP4 synthesises the results of SP1, SP2 and SP3 to develop integrated clinical pathways, identifying strategies to uphold oral healthcare in older people. In assessing and evaluating the process of oral healthcare, and its associated systemic morbidity, InSEMaP aims to improve general healthcare across the sector boundary of dental and general practitioner care.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Institutional Review Board of the Hamburg Medical Chamber (approval number: 2021-100715-BO-ff). The results of this study will be disseminated through conference presentations and publications in peer-reviewed journals. An expert advisory board to support the InSEMaP study group will be established.

TRIAL REGISTRATION NUMBER

German Clinical Trials Register: DRKS00027020.

摘要

简介

需要家庭护理的老年人由于行动不便，看牙医的次数减少，口腔健康状况可能会恶化。越来越多的证据表明，口腔健康状况不佳与系统性疾病密切相关，例如在心血管、代谢或神经退行性疾病中。因此，需要家庭护理的门诊患者的系统性疾病与口腔健康的相互作用（InSEMaP）研究调查了老年人对口腔保健的需求、提供和利用、系统性疾病和口腔临床状况。

方法和分析

InSEMaP 由四个子项目（SP）组成，均涉及需要家庭护理的老年人这一目标人群。在 SP1 部分 a 中，使用自我报告问卷对样本进行调查。在 SP1 部分 b 中，通过焦点小组和个人访谈，对利益相关者（全科医生、牙医、医疗助理、家庭和专业护理人员）进行访谈，以了解障碍和促进因素。在 SP2 中，将回顾性队列研究，检查健康保险索赔数据，以调查口腔保健的利用情况及其与系统性疾病和医疗保健费用的关系。在 SP3 中，将通过牙医家访来评估参与者的口腔健康。SP4 综合了 SP1、SP2 和 SP3 的结果，制定综合临床路径，确定在老年人中维持口腔保健的策略。InSEMaP 在评估和评估口腔保健过程及其相关的系统性疾病时，旨在改善牙科和全科医生护理部门之间的整体医疗保健。