Antibiotic prescribing in dental primary care Oral Health
Conditions
Interventions
Current interventions as of 30/04/2024:
Participating practices will be randomised to either the control group (standard infection control training and individualised audit and feedback) or the inte
Sponsors
NHS Education for Scotland
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Dental practices: NHS General Dental Practices across the 14 Health Boards in Scotland booked to receive QIiPT infection control training Dentists: Dentists working in a practice which has booked QIiPT infection control training and has agreed to take part in TiPTAP Dentists in eligible and participating practices with an ordinary list number recorded in MIDAS
Exclusion criteria
Exclusion criteria: Current participant exclusion criteria as of 18/06/2021: Dental practices: 1. Practices which have not received QIiPT IC training in the past 5 years 2. Practices in mainland Health Boards in which any dentists are salaried. Salaried dentists are used as a proxy to identify community and emergency dental services). Predominantly due to geography, the majority of dental services in the Island Health Boards are provided by the NHS salaried service. For this reason, practices with salaried dentists in the Island Health Boards are not excluded 3. Practices where no ordinary list claims are made in more than 6 months out of the most recently available 24 months of MIDAS data at the time of baseline 4. Practices where no antibiotic items have been prescribed in more than 6 months out of the most recently available 24 months of PRISMS data at the time of baseline Dentists: 1. Dentists not working in a practice which has booked QIiPT IC training and has agreed to take part in TiPTAP 2. Dentists in eligible and participating practices who do not have an ordinary list number recorded in MIDAS Previous participant exclusion criteria: Dental practices: 1. Practices which have not received QIiPT IC training in the past 4 years 2. Practices which participated in TiPTAP feasibility and acceptability work 3. Practices which have previously received TiPTAP training 4. Practices in mainland Health Boards in which any dentists are salaried. Salaried dentists are used as a proxy to identify community and emergency dental services). Predominantly due to geography, the majority of dental services in the Island Health Boards are provided by the NHS salaried service. For this reason, practices with salaried dentists in the Island Health Boards are not excluded 5. Practices where no ordinary list claims are made in more than 6 months out of the most recently available 12 months of MIDAS data at the time of baseline 6. Practices where no antibiotic items have been prescribed in more than 6 months out of the most recently available 12 months of PRISMS data at the time of baseline Dentists: 1. Dentists not working in a practice which has booked QIiPT IC training and has agreed to take part in TiPTAP 2. Dentists in eligible and participating practices who do not have an ordinary list number recorded in MIDAS
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The number of antibiotic items per 100 NHS treatment claims: PRISMS prescribing data and MIDAS treatment claim data will be linked via the Prescriber reference in PRISMS and the List Number in MIDAS. This linked database will be used to measure both the primary and secondary outcomes. The calculation used to generate monthly individual prescribing rates is (total number of antibiotic items prescribed / total number of treatment claims)*100. Measured over a 1-year period post-randomisation per dentist (with specific timepoints of interest being 6- and 12-months post-randomisation). | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 30/04/2024: 1. Total number of amoxicillin 3 g items per 100 NHS treatment claims 2. Total number of “second-line” antibiotic items (Clindamycin, Co-amoxiclav, Clarithromycin, Cefalexin, and Cefradine) per 100 claims 3. Defined daily doses of antibiotics per 100 claims 4. Defined daily doses of amoxicillin 3 g per 100 claims 5. Defined daily doses of “second-line” antibiotics (Clindamycin, Co-amoxiclav, Clarithromycin, Cefalexin and Cefradine) per 100 claims PRISMS prescribing data and MIDAS treatment claim data will be linked via the Prescriber reference in PRISMS and the List Number in MIDAS. This linked database will be used to measure both the primary and secondary outcomes. The calculation used to generate monthly individual prescribing rates is (total number of antibiotic items prescribed / total number of treatment claims)*100. Measured over a 1-year period post-randomisation per dentist (with specific timepoints of interest being 6- and 12-months post-randomisation). Process measures A post training questionnaire will assess fidelity, knowledge and confidence. Training session observations and QIiPT team records will detail whether the practices received the intervention as intended. Interviews will take place with participants and trainers in order to further examine the implementation and impact of the trial. _____ Previous secondary outcome measures: 1. Total number of amoxicillin 3 g items per 100 NHS treatment claims 2. Total number of “second-line” antibiotic items (Clindamycin, Co-amoxiclav, Clarithromycin, Cefalexin, and Cefradine) per 100 claims 3. Defined daily doses of antibiotics per 100 claims 4. Defined daily doses of amoxicillin 3 g per 100 claims 5. Defined daily doses of “second-line” antibiotics (Clindamycin, Co-amoxiclav, Clarithromycin, Cefalexin and Cefradine) per 100 claims PRISMS prescribing data and MIDAS treatment claim data will be linked via the Prescriber reference in PRISMS and the L | — |
Countries
Scotland, United Kingdom
Contacts
Public ContactClaire Scott
Outcome results
None listed