Integrating Medical-Dental Care for Diabetic Patients: Qualitative Assessment of Provider Perspectives.
Integrating Medical-Dental Care for Diabetic Patients: Qualitative Assessment of Provider Perspectives.
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DOI：
10.1177/1524839917737752
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发表时间：
2018-07
影响因子：
1.9
通讯作者：
Acharya A
中科院分区：
文献类型：
--
作者：
Glurich I;Schwei KM;Lindberg S;Shimpi N;Acharya A
在全球范围内，牙周病和糖尿病已达到流行病的程度，并已成为医疗保健的首要重点。相互双向恶化这些条件驱动的潜在炎症过程已被证明。跨学科综合护理服务（ICD）模式的创建正在推进，该模式将传统上孤立的牙科和医学医疗保健领域连接起来，以改善对这两种疾病的管理。通过包括医疗和牙科提供者在内的焦点小组和一对一访谈，本定性研究调查了提供者的知识、接受程度和参与ICD的准备情况，并从医疗/牙科初级保健从业者参与者那里寻求实现糖尿病/前驱糖尿病患者ICD模型的机会、好处和挑战。在征求参与者时，强调了全州范围内的区域代表性和不同实践环境的包容性。对焦点小组和访谈记录进行专题分析，以建立当前最先进的技术，衡量对替代性ICD模型的接受程度，并从从业者那里寻求关于实现ICD的机会和障碍的见解。40家供应商参与，专题分析达到饱和。提供者充分了解疾病相互作用，接受ICD，包括实施更好的筛查和转诊程序，并赞成改善跨学科交流，包括获取综合电子健康记录。与会者就推进ICD所传达的障碍和机会进行了记录。
Globally, periodontal disease and diabetes have achieved epidemic proportions and have become a top healthcare priority. Mutual bidirectional exacerbation of these conditions driven by underlying inflammatory processes has been demonstrated. Creation of cross-disciplinary integrated care delivery (ICD) models that bridge the traditionally-siloed healthcare domains of dentistry and medicine are being advanced to improve management of both conditions. By engaging focus groups inclusive of both medical and dental providers and one-on-one interviews, this qualitative study investigated provider knowledgeability, receptiveness, and readiness to engage ICD and sought input from the medical/dental primary care practitioner participants on perceived opportunities, benefits, and challenges to achieving ICD models for patients with diabetes/prediabetes. Statewide regional representation and inclusivity of diverse practice settings were emphasized in soliciting participants. Thematic analysis of focus group and interview transcripts was undertaken to establish current state-of-the-art, gauge receptivity to alternative ICD models, and seek insights from practitioners surrounding opportunities and barriers to ICD achievement. Forty providers participated, and thematic analyses achieved saturation. Providers were well informed regarding disease interaction, receptive to ICD, including implementation of better screening and referral processes, and favored improving interdisciplinary communication inclusive of access to integrated electronic health records. Perceived barriers and opportunities communicated by participants for advancing ICD were documented.