O'Neill Ciaran, Brocklehurst Paul R, Syed Saif, Harvey Michelle, Daniyal Sana, Watson Sinead, Goulden Nia, Verey Anna, Cairns Peter, Heilmann Anja, Hoare Zoe, Kee Frank, Langley Joe, Lievesley Nat, Sherriff Andrea, Smith Craig J, Wassall Rebecca R, Watt Richard G, McKenna Gerald, Tsakos Georgios
Centre for Public Health, Queens University Belfast, Belfast, UK.
Public Health Wales, Cardiff, UK.
BMC Oral Health. 2025 Jul 2;25(1):1062. doi: 10.1186/s12903-025-06322-6.
In the UK older adults in care homes have exhibited poorer oral health than age-equivalent persons in the community. In response the National Institute for Health and Care Excellence issued guidance (NG48) on the maintenance and improvement of oral health in this group. Currently, there is little evidence on the cost-effectiveness of such interventions. The aim of this study was to examine the feasibility of evaluating an intervention framed around NICE guidance.
The study was undertaken in 22 care homes across 2 sites with eligibility criteria used to ensure access to residents for whom the oral health care intervention was relevant and who could consent to participation. The intervention followed the guidance issued by NICE in respect of care staff knowledge; oral health assessment and development of care plans, and provision of daily mouth care to residents. Quantitative and qualitative data were collected from residents and care home managers and interviews undertaken with a range of stakeholders. Quantitative data from residents comprised EQ5D5L at baseline, 6 and 12 months, qualitiative data was taken from interviews. Descriptive statistics and a discussion of themes raised in surveys and interviews was undertaken. The trial was registered with the UK's Clinical Study Registry (ISRCTN10276613) on 17/04/2020.
Of 119 residents recruited, 115 provided usable EQ5D5L data at baseline. The data had good face validity. Managers from 7 of 22 homes provided responses to the care home survey. All responding care homes routinely recorded information on care provided to residents and 5 of the 7 recorded information on the funding source for that care. Care assistant time was a key consideration among managers in terms of resource use. Residents overall quality of life was a key consideration among managers in terms of outcomes. Among key stakeholders, there was a universal appreciation of the need to improve the evidence base on the value for money of interventions framed around NG48.
The study supports the case for the conduct of an economic evaluation in a definitive trial to address a manifest gap in the evidence base on oral hygiene interventions in this context.
在英国，养老院中的老年人口腔健康状况比社区中同龄人群更差。作为回应，英国国家卫生与临床优化研究所发布了关于该群体口腔健康维护与改善的指南（NG48）。目前，关于此类干预措施的成本效益几乎没有证据。本研究的目的是检验围绕英国国家卫生与临床优化研究所指南构建的一项干预措施评估的可行性。
该研究在两个地点的22家养老院进行，采用入选标准以确保能够接触到与口腔保健干预相关且能够同意参与的居民。干预措施遵循英国国家卫生与临床优化研究所发布的关于护理人员知识、口腔健康评估与护理计划制定以及为居民提供日常口腔护理的指南。从居民和养老院管理人员处收集定量和定性数据，并与一系列利益相关者进行访谈。居民的定量数据包括基线、6个月和12个月时的EQ5D5L，定性数据来自访谈。进行了描述性统计以及对调查和访谈中提出的主题的讨论。该试验于2020年4月17日在英国临床研究注册中心注册（ISRCTN10276613）。
在招募的119名居民中，115名在基线时提供了可用的EQ5D5L数据。这些数据具有良好的表面效度。22家养老院中有7家的管理人员对养老院调查做出了回应。所有做出回应的养老院都常规记录了提供给居民的护理信息，7家中有5家记录了该护理的资金来源信息。就资源使用而言，护理助理的时间是管理人员的关键考虑因素。就结果而言，居民的总体生活质量是管理人员的关键考虑因素。在主要利益相关者中，大家普遍认识到需要改进围绕NG48构建的干预措施性价比的证据基础。
该研究支持在确定性试验中进行经济评估的理由，以填补在此背景下口腔卫生干预证据基础中明显的空白。
