Clinical practice guidelines derived from the best available evidence, which aim at reducing inappropriate variation in practice, can be one way to provide evidence based health care and be effective in bringing about change and improving clinical practice. However a diagnostic approach to change management is required to identify factors likely to influence the proposed change followed by appropriate interventions implemented to change practice. Current guidelines for prevention of infective endocarditis recommend many fewer patients receive antibiotic prophylaxis prior to dental treatment. The studies in this thesis are designed to address effective implementation of these guidelines in primary dental care. -- The thesis consists of four studies: -- Questionnaire survey of dentists to determine the knowledge and application of current expert recommendations on antibiotic prophylaxis to prevent infective endocarditis in at risk patients in two different countries: UK and Iran -- A qualitative study asking practitioners about their views about the adoption of current guidance on antibiotic prophylaxis in their practice. -- A qualitative study investigating patients' perspectives and understanding of antibiotic prophylaxis in dentistry. -- A randomised controlled trial to evaluate an intervention which targeted the identified barriers to change. -- Iranian dentists showed a preference for the American Heart Association guidelines and more dentists in the UK used British National Formulary. Dentists in the UK were more familiar than Iranian dentists with the antibiotic prophylaxis guidelines that were current at the time of the survey, although potential for over-prescription of antibiotic prophylaxis was identified in two groups.-- A qualitative study investigating patientsa#39; perspectives and understanding of antibiotic prophylaxis in dentistry. -- A randomised controlled trial to evaluate an intervention which targeted the identified barriers to change.
|Title||:||Implementation of Evidence Based Practice in Primary Dental Care|
|Author||:||Shimae Soheilipour, King's College London. Guy's, King's and St. Thomas's School of Dentistry|