Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs 2015 Guidance
The need for national guidance on this topic arose from concerns about the lack of clarity around dental specific recommendations for the new drugs, and uncertainty about referral for these patients. The guidance aimed to clarify recommendations and expert advice for the newer oral anticoagulants and antiplatelet drugs and present these, along with up-to-date recommendations for the more established medications, within a single information resource. To inform the development of the guidance, the following work was carried out by TRiaDS:
Informing the Scope of the Guidance
The scope of the guidance was informed by conducting telephone interviews with sixteen general dental practitioners (GDPs) from both rural and city practices from across Scotland. The aim was to identify current practice and factors which may influence the management of patients taking these drugs. The interviews also helped establish what dentists wanted from this guidance.
A patient questionnaire (PDF) was developed to ensure that patients’ views were represented in the guidance. The questionnaire was distributed using two routes: (i) It was posted on three charity websites: Anticoagulation Europe; the Atrial Fibrillation Association; The Stroke Association, and (ii) It was also distributed (face-to-face) through anticoagulation clinics in NHS Tayside with the help of colleagues from the Scottish Health Council. A summary report (PDF) [accessible version (Word)] is available.
Diagnostic Analyses
Diagnostic analyses comprised of four stages: consultation feedback questionnaire; semi-structured telephone interviews; pre-guidance publication questionnaire; post-guidance publication questionnaire.
1. Consultation feedback questionnaire
As part of SDCEP’s consultation process the draft guidance was circulated to organisational and individual stakeholders including GDPs for feedback. A number of questions focusing on the barriers and facilitators to implementation were included in the consultation feedback form.
2. Semi-structured telephone interviews
Dentists (GDPs) and dental hygienists (DHs) took part in interviews during the consultation period. Feedback gathered at consultation informed the interview questions which aimed to identify salient beliefs regarding the barriers and facilitators related to the implementation of the recommendations in the draft guidance.
3. Pre-guidance publication questionnaire
A questionnaire underpinned by the Theoretical Domains Framework was sent to a random sample of GDPs across Scotland six weeks prior to the publication and dissemination of the guidance. The content of the questionnaire was informed by the findings of the consultation feedback and the interviews.
4. Post-guidance publication questionnaire
A post-guidance questionnaire was distributed six months after publication to identify any changes in practice following publication and dissemination of this SDCEP guidance.