Palmier-Claus Jasper, Morris Abigail, French Paul, Griffiths Robert, Aggarwal Vishal R, Berry Katherine, Gkioni Efstathia, Harris Rebecca, Laverty Louise, Lobban Fiona, Procter Sarah, Kerry Eirian, Newens Connie, Mupinga Pauline, Golby Rebecca, Valemis Kyriakos, Oakes Lucy, Fazekas Fanni, Perry Antonia, Shiers David, Lodge Christopher, Hilton Claire, Dawber Alison, Elliott Emma, Lunat Farah, Burnside Girvan
The Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
Lancashire & South Cumbria NHS Foundation Trust, Preston, Lancashire, UK.
Community Dent Oral Epidemiol. 2025 Oct;53(5):580-586. doi: 10.1111/cdoe.70002. Epub 2025 Aug 4.
People with severe mental illness experience poor oral health, compared to the general population. They experience inequity in accessing dental services. This randomised controlled trial evaluated the acceptability and feasibility of a link work intervention to support people with severe mental illness to access a routine dental appointment.
This was a feasibility randomised controlled trial across three sites with 1:1 allocation to Treatment as usual (TAU) or TAU plus a link work intervention (ISRCTN13650779). Participants were adults accessing mental health services who had not attended a routine dental appointment in the past 3 years. The intervention comprised up to six sessions with a link worker. Participants completed self-report assessments and an optional dental examination at baseline and after nine months. Dental visiting data were obtained through self-report and the NHS Business Services Authority (BSA).
One hundred and sixty-one participants were referred into the trial, resulting in 79 out of the target 84 randomisations (94.0%) over 7 months. There were high levels of engagement with the intervention. Dental visiting data were available for 84.8% of participants (95% CI: 75.3%, 91.1%). Uptake of the optional dental examination within the research assessment battery was low (follow-up: 12.7%; 95% CI: 7.0%, 21.8%). There were no serious adverse events attributable to the intervention or trial procedures. There were substantially higher rates of dental attendance after nine months in the link work intervention arm, compared to TAU, in both the self-report (91.7% vs. 26.7%) and NHS BSA (55.3% vs. 12.1%) data. There was also a signal of improved self-reported oral health-related quality of life favouring the link work intervention arm.
The trial procedures and link work intervention were found to be feasible, acceptable and safe. The intervention showed promise in terms of clinical outcomes. The effectiveness of the intervention requires evaluation in a larger trial.
NCT05545228.
与普通人群相比，患有严重精神疾病的人口腔健康状况较差。他们在获得牙科服务方面存在不平等现象。这项随机对照试验评估了一种联络工作干预措施的可接受性和可行性，该措施旨在帮助患有严重精神疾病的人获得常规牙科预约。
这是一项在三个地点进行的可行性随机对照试验，按1:1的比例分配到常规治疗（TAU）组或TAU加联络工作干预组（ISRCTN13650779）。参与者为成年心理健康服务使用者，他们在过去3年中未进行过常规牙科预约。干预措施包括与一名联络工作人员进行最多六次会面。参与者在基线和九个月后完成自我报告评估以及一次可选的牙科检查。通过自我报告和英国国家医疗服务体系商业服务管理局（BSA）获取牙科就诊数据。
161名参与者被纳入试验，在7个月内完成了目标84次随机分组中的79次（94.0%）。对干预措施的参与度很高。84.8%的参与者有牙科就诊数据（95%置信区间：75.3%，91.1%）。在研究评估组中，可选牙科检查的接受率较低（随访时：12.7%；95%置信区间：7.0%，21.8%）。没有可归因于干预措施或试验程序的严重不良事件。在自我报告数据（91.7%对26.7%）和NHS BSA数据（55.3%对12.1%）中，联络工作干预组在九个月后的牙科就诊率均显著高于TAU组。还有迹象表明，联络工作干预组自我报告的口腔健康相关生活质量有所改善。
试验程序和联络工作干预措施被认为是可行、可接受且安全的。该干预措施在临床结果方面显示出前景。该干预措施的有效性需要在更大规模的试验中进行评估。
NCT05545228。
