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Using An Educational Prescription
Transcript of Using An Educational Prescription
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© Dr Dominic Hurst, 2014
Using an Educational Prescription
Help us use research in our practice
Reinforce learning about finding research most appropriate to questions asked
Identify a clinical problem from our practice
Create a structured question to help clarify what we want to know and help searching
Develop search skills
Encourage us to critically evaluate the best information / evidence we find
Think about how we incorporate this into our patients' care
Intervention / prevention question
Randomised controlled trial (I'll look for a systematic review of these or guidelines too)
I don't know whether this intervention is more effective than normal OHI
I want to be able to help my patients improve their oral hygiene. I have heard about motivational interviewing and would like to know if it is effective.
Patients with poor oral hygiene
Standard oral hygiene advice
Improved oral hygiene
TRIP database using "motivational interviewing oral health"
If needed :)
Gao X, Man Lo EC, Ching Ching Kot S, Wai Chan KC. Motivational Interviewing in Improving Oral Health: A Systematic Review of Randomized Controlled Trials. Journal of periodontology. 2013 Jun 27.
They didn't do a meta-analysis but found that in out of 7 studies MI was more effective than usual care but in 2 of the 7 it wasn't.
The review searched several databases, included only RCTs and evaluated the risk of bias in the individual studies. The studies themselves were generally at medium or high risk of bias so we should be careful in interpreting the results.
There would be no harm in me trying to use MI as there do not appear to be harmful side-effects and it has been shown to be effective in other areas.
I realise that I need to learn how to do motivational interviewing so I have identified some sources to help me learn. These include the website www.motivationalinterview.org and a book "Motivational Interviewing in Health Care: Helping Patients Change Behavior". Two of my friends are also interested so we will discuss how we can do this and practice with each other.
Then I plan to use the techniques in 4 weeks' time and monitor how long it takes and whether or not plaque scores improve more than before I tried it.
Yes - it could. I already spend a lot of time giving oral hygiene advice so, assuming it doesn't take longer then this should be practical. I do, though, need to learn how to do it but this shouldn't be a major barrier.
dd/mm/yyyy Dr Bob Sinclair
If you find several studies then include them all, if appropriate