Exploring the Feasibility and Acceptance of Delivering Oral Health Interventions in a Primary Care Diabetes Context in North East England: A Qualitative Two-Case Study.

Abstract

The evidence base supporting a bidirectional relationship between diabetes and periodontitis is well-established and published guidance recommends inter-professional management. This two-case study describes the development and implementation of an evidence-based oral health intervention delivered in diabetes review consultations in NHS primary medical care in Northeast England.

Aim: The intervention aim was to inform people with diabetes about the links between diabetes and periodontitis, and signpost them to a dental professional for assessment.

Methods: The study utilised focus groups in the design phase and a mixture of focus groups and interviews in the evaluation phase.

Results: Two research active primary care medical practices were recruited. The interventions were informed by their diabetes management protocols to reduce disruption. The interventions were piloted for 2 months, and staff and patient perceptions were evaluated. The findings from this study suggested that the oral health interventions were feasible and acceptable particularly for nurses and health care assistants when delivering diabetes education, but they caused disruption to the GPs review, which included complex medication reviews and referrals. The patients (n = 2) found the intervention to be acceptable and appropriate in the context of their diabetes review.

Conclusion: Medical staff and patient evaluation data appear to suggest acceptance of the introduction of an oral health intervention into the diabetes review, but it is difficult to assess the impact of the intervention. Further research, such as a realist review, is needed to evaluate the outcomes and utility of an oral health intervention in the context of the medical management of diabetes in primary care.