Monitoring oral health of people in Early Intervention for Psychosis (EIP) teams: The extended Three Shires randomised trial
Section snippets
Background
The UK’s Five Year Forward View for Mental Health (Mental Health Task Force, 2016) highlights that people with mental health problems have poorer physical health than the general population. Often this group are unable to access the physical healthcare they need and experience unnecessary health inequalities. Given this context the UK’s Department of Health (DoH) has produced guidance (Nursing Midwifery and Allied Health Professions Policy Unit, 2016) to address the physical healthcare,
Objectives
To acquire basic data on the oral health of people with or at risk of serious mental illness.
To determine the effects of oral health advice or monitoring in routine clinical practice.
Specifically we wished to examine whether dental monitoring with minimal dental awareness training leads to a clinically significant difference in oral health behaviour of people with serious mental illness.
Methods
Detailed methods are published elsewhere (Jones et al., 2013) but described briefly in the sections below.
Results
Recruitment of teams (n = 35) took place across 2012–3 and follow up was for one year. The intervention teams returned 882 baseline intervention forms and the matching of control group allowed estimation of numbers of clients within the control teams to be broadly similar (Fig. 2). The intervention teams returned 274 outcome sheets one year after their initial baseline form. Two control teams returned no forms, and we gained 366 from the remaining 15 (Fig. 2). Not all returned forms were
Discussion
The demographics of the sample reflect what would be expected in most early intervention teams (Purcell et al., 2015). Around a quarter of our sample felt they were not registered with a dentist. We are unsure of how this compares with the wider population but think this is likely to indicate early signs of disengagement with dental services. Comparison with UK normative data of the 2009 Adult Dental Health Survey (ADHS) highlights how more of this sample had visited a dentist in the preceding
Conclusions
We found no evidence that a reminder checklist had any effect at the end of one year follow up. Our trial had poor follow up and it is possible that this finding is true or false. If true, and generalizable across different health checklists, there remains the possibility of enormous waste of resource in asking health care professionals to undertake such checklists for purposes of audit rather than for any valuable clinical outcome. It is, however, also possible that a real effect was missed by
Funding
This paper presents independent research commissioned by the National Institute for Health research (NIHR) as part of the Collaboration for Leadership in Applied Health Research and Care Nottinghamshire, Derbyshire and Lincolnshire (CLAHRC-NDL).
The views expressed in this paper are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
Participants were not paid to participate in the trial but were refunded any costs for travel beyond receiving
Declaration of interest
No authors have any pecuniary interest in the results of this work. There are no conflicts of interest.
Acknowledgements
Dianne Whitham of the NCTU – for support and care well beyond the call of duty. Natalie Murphy, then head of physical healthcare in Notts HC supported the study early on. The late Professor Aubrey Sheiham of the London School of Hygiene and Tropical Medicine had been supportive and provided intermittent advice for the project that has been so useful. All the service users, Care Co-ordinators and team managers who assisted us in conducting this trial and gave us so much of their time and
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