Karuveettil Vineetha, Sapna Swati, Jain Praneetha, Anand Gurleen Kaur
Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Amrita Centre for Evidence Based Oral Health: A JBI Centre of Excellence, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Evid Based Dent. 2025 May 12. doi: 10.1038/s41432-025-01148-1.
Oral diseases are a major public health concern in Low and Middle Income Countries (LMICs), where effective treatment requires multiple appointments. Despite its importance, limited research has explored appointment adherence among adults in these settings. This scoping review identifies the barriers and facilitators to attending dental care appointments in LMICs.
The current review followed JBI Scoping Review Methodology. The Databases of Dentistry, Oral Sciences Source (EBSCO), MEDLINE (Ovid), Embase (Ovid), Cochrane CENTRAL, Scopus and grey literature sources were searched systematically from inception till November 2024. Two independent reviewers performed data extraction using a customized JBI data extraction form. The Theoretical Domains Framework categorized barriers and facilitators of dental appointment keeping. Findings were tabulated and synthesized narratively with recommendations to improve dental attendance.
Ten articles met the inclusion criteria after being screened through 5571 titles, abstracts, and 210 full texts. Knowledge, social and professional roles and identity, beliefs about capabilities, consequences, memory, attention, decision-making processes, environmental context and resources, social influence, and emotion are the main domains under which barriers and facilitators were identified. Environmental context and resource constraints were the most common barriers, while social influence was the main facilitator. The dental appointment adherence issues were determined to be comparable in public practice and university settings.
It is necessary to acknowledge the barriers and facilitators to dental appointment keeping to improve the effectiveness of the dental health system, ensure continuity of care, and encourage better patient-doctor relationships. Tailored interventions are required in the dental setting to effectively manage and reduce disparities in patient care.
口腔疾病是低收入和中等收入国家（LMICs）主要的公共卫生问题，在这些国家，有效的治疗需要多次就诊。尽管其重要性，但在这些环境中，针对成年人就诊依从性的研究有限。本范围综述确定了低收入和中等收入国家在接受牙科护理预约方面的障碍和促进因素。
本次综述遵循乔安娜布里格斯研究所（JBI）范围综述方法。从数据库建立之初到2024年11月，系统检索了牙科数据库、口腔科学源数据库（EBSCO）、医学期刊数据库（Ovid）、Embase数据库（Ovid）、考克兰系统评价数据库、Scopus数据库以及灰色文献来源。两名独立评审员使用定制的JBI数据提取表进行数据提取。理论领域框架对牙科预约遵守情况的障碍和促进因素进行了分类。研究结果被制成表格，并进行叙述性综合，并提出了改善牙科就诊率的建议。
在对5571篇标题、摘要和210篇全文进行筛选后，有10篇文章符合纳入标准。知识、社会和职业角色与身份、对能力的信念、后果、记忆、注意力、决策过程、环境背景与资源、社会影响和情感是识别出障碍和促进因素的主要领域。环境背景和资源限制是最常见的障碍，而社会影响是主要的促进因素。牙科预约遵守问题在公共诊所和大学环境中被认为是相当的。
有必要认识到牙科预约遵守方面的障碍和促进因素，以提高牙科卫生系统的有效性，确保护理的连续性，并鼓励建立更好的医患关系。在牙科环境中需要采取针对性干预措施，以有效管理和减少患者护理方面的差异。
