Knowledgeability, attitude, and practice behaviors of primary care providers toward managing patients' oral health care in medical practice: Wisconsin statewide survey.

BACKGROUND In this study, the authors sought to explore the receptivity, preparedness, and rates of adoption of integrated medical-dental models of care (MOCs) in the practice setting among primary care providers (PCPs) treating patients with diabetes mellitus (DM). METHODS The authors conducted an anonymous statewide survey targeting PCPs across a range of Wisconsin-based practice settings to evaluate knowledgeability, attitude, practice behaviors, and perceived barriers to oral health screening in a medical setting. Qualitative analytical approaches included thematic analyses applied to evaluate the status of and barriers to integrated medical-dental MOC adoption. RESULTS The integrated medical-dental MOC adoption rate was 34%. Top perceived barriers to integrated medical-dental MOC adoption included insurance coverage (71%) and care access (70%). A total of 39% indicated competency for educating patients about the association between DM and periodontitis. Although 72% of PCPs indicated optimal periodicity for oral health assessment as frequent, 39% reported frequently conducting such assessments. CONCLUSIONS Although PCPs indicate receptivity to integrated medical-dental MOCs, PCPs identify suboptimal education, lack of adequate training in oral-systemic disease assessment, and barriers to oral health care access as barriers to integrated medical-dental MOC adoption. PRACTICAL IMPLICATIONS Integrated medical-dental MOC adoption in care delivery to patients with DM remains below average. Interdisciplinary efforts and education are needed to address identified barriers to care integration.

[1]  T. Haraldson,et al.  Periodontal Status and Bruxism , 1987 .

[2]  P. Eke,et al.  Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014. , 2018, Journal of the American Dental Association.

[3]  Lise Lamothe,et al.  Barriers and facilitators in the integration of oral health into primary care: a scoping review , 2017, BMJ Open.

[4]  J. Hummel,et al.  Oral Health in Primary Care , 2016, JDR clinical and translational research.

[5]  P. Chyou,et al.  Patient Awareness of Association of Diabetes and Periodontal Disease , 2018, Health promotion practice.

[6]  P. Chyou,et al.  Knowledgeability, Attitude and Behavior of Primary Care Providers Towards Oral Cancer: a Pilot Study , 2018, Journal of Cancer Education.

[7]  L. Manzon,et al.  Use of Psychotropic Drugs and Associated Dental Diseases , 2014, International journal of psychiatry in medicine.

[8]  M. Välimäki,et al.  A mixed-mode approach to data collection: combining web and paper questionnaires to examine nurses' attitudes to mental illness. , 2010, Journal of advanced nursing.

[9]  S. Lindberg,et al.  Integrating Medical-Dental Care for Diabetic Patients: Qualitative Assessment of Provider Perspectives , 2018, Health promotion practice.

[10]  Amit Acharya,et al.  An Integrated Medical-Dental Electronic Health Record Environment: A Marshfield Experience , 2012, Integration of Medical and Dental Care and Patient Data.

[11]  R. Sharifi,et al.  Prevalence of Oral Lichen Planus in Diabetes Mellitus: a Meta-Analysis Study , 2016, Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH.

[12]  J. Jones,et al.  Integrated Medical-Dental Delivery Systems: Models in a Changing Environment and Their Implications for Dental Education. , 2017, Journal of dental education.

[13]  P. Chyou,et al.  Statistical Application and Cost Saving in a Dental Survey , 2017, Clinical Medicine & Research.

[14]  R. Berg,et al.  Screening for dysglycaemia in dental primary care practice settings: systematic review of the evidence. , 2018, International dental journal.

[15]  R. Rozier,et al.  Adoption and implementation of policies to support preventive dentistry initiatives for physicians: a national survey of Medicaid programs. , 2013, American journal of public health.

[16]  G. Thornton-Evans,et al.  U.S. Department of Health and Human Services Oral Health Strategic Framework, 2014–2017 , 2016 .

[17]  P. Chyou,et al.  Medical Providers' Oral Health Knowledgeability, Attitudes, and Practice Behaviors: An Opportunity for Interprofessional Collaboration. , 2016, The journal of evidence-based dental practice.

[18]  J. Ship,et al.  Systemic diseases and their treatments in the elderly: impact on oral health. , 2000, Journal of public health dentistry.

[19]  S. Gansky,et al.  Oral Health Prevention and Toddler Well-Child Care: Routine Integration in a Safety Net System , 2016, Pediatrics.

[20]  P. Harris,et al.  Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support , 2009, J. Biomed. Informatics.

[21]  Neel A. Shimpi,et al.  Need for diagnostic-centric care in dentistry: A case study from the Marshfield Clinic Health System. , 2018, Journal of the American Dental Association.

[22]  A. Douglass,et al.  Smiles for Life: A National Oral Health Curriculum for Family Medicine. A model for curriculum development by STFM groups. , 2007, Family medicine.

[23]  P. Eke,et al.  Update of the case definitions for population-based surveillance of periodontitis. , 2012, Journal of periodontology.

[24]  Brian L Mealey,et al.  Periodontal disease and diabetes. A two-way street. , 2006, Journal of the American Dental Association.

[25]  I. Glurich,et al.  Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients , 2017, Clinical Medicine & Research.

[26]  Terence Tang,et al.  Clinician user involvement in the real world: Designing an electronic tool to improve interprofessional communication and collaboration in a hospital setting , 2018, Int. J. Medical Informatics.

[27]  Amit Acharya,et al.  Interdisciplinary Care Model: Chronic Kidney Disease and Oral Health , 2018, Integration of Medical and Dental Care and Patient Data.

[28]  Amitav Acharya Marshfield Clinic Health System: Integrated Care Case Study. , 2016, Journal of the California Dental Association.

[29]  Amit Acharya,et al.  Interdisciplinary Care Model: Diabetes and Oral Health , 2018, Integration of Medical and Dental Care and Patient Data.

[30]  Neel A. Shimpi,et al.  Medical care providers' perspectives on dental information needs in electronic health records. , 2017, Journal of the American Dental Association.

[31]  T. Barnett,et al.  Non-dental primary care providers’ views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study , 2015, BMJ Open.

[32]  Bruxism-Related Signs and Periodontal Disease: A Preliminary Study , 2018, The open dentistry journal.

[33]  P. Chyou,et al.  Assessment of Dental Providers’ Knowledge, Behavior and Attitude towards Incorporating Chairside Screening for Medical Conditions: A Pilot Study , 2016 .

[34]  D. Satcher,et al.  Revisiting Oral Health in America: A Report of the Surgeon General , 2017, American journal of public health.

[35]  Leonard A Cohen,et al.  Expanding the physician's role in addressing the oral health of adults. , 2013, American journal of public health.

[36]  C. Scully,et al.  Global burden of oral diseases: emerging concepts, management and interplay with systemic health. , 2016, Oral diseases.

[37]  Amit Acharya,et al.  Interdisciplinary Care Model: Pneumonia and Oral Health , 2018, Integration of Medical and Dental Care and Patient Data.

[38]  R. Donoff,et al.  The Impact of Integrating Oral Health Education into a Medical Curriculum , 2016, Medical Principles and Practice.

[39]  P. Eke,et al.  Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012. , 2015, Journal of periodontology.

[40]  Amit Acharya,et al.  Interdisciplinary Care Model: Cardiovascular Diseases and Oral Health , 2018, Integration of Medical and Dental Care and Patient Data.