IADR Abstract Archives
Antibiotic Prescribing: Towards a reducTion in Urgent Dentistry in England (APTiTUDE)
Objectives: My research aimed to develop an evidence-based, theory-informed bundle of interventions to reduce antibiotic prescribing by NHS dentists for patients with toothache and/or infection in England.
Methods: First, I explored what influenced treatment (including antibiotic prescribing) during actual urgent dental appointments in high-street practices and out-of-hours clinics. Based on my observations and what patients, dentists and dental nurses later told me by telephone, I produced a list of factors associated with treatment decisions. Next, people with experience of receiving urgent dental care, dental team members and NHS managers worked together to prioritise factors for my future work. Finally, using behavioural science (the Theoretical Domains Framework and the Theory&Techniques of Behaviour ChangeTool), I designed tools aimed at reducing antibiotic prescribing by tackling these priority factors.
Results: The bundle of interventions developed included two new communication and engagement tools. One was for use before and during urgent dental appointments, the other was a drama-based tool for engaging a wider audience. Because ‘antibiotic beliefs’ was the only factor found to influence dentists and patients and dental nurses, providing ‘information about consequences’ (a known way to address behaviours driven by 'beliefs and consequences') was at the heart of the communication and engagement tools developed. A selection of other priority factors identified during the research were also included in the intervention design.
Conclusions: To slow the spread of antibiotic resistant infections, clinicians are encouraged to use antibiotics only when necessary. Two evidence-based, theory-informed behaviour change interventions have been developed to complement tools already within the UK dental antimicrobial stewardship toolkit.
Methods: First, I explored what influenced treatment (including antibiotic prescribing) during actual urgent dental appointments in high-street practices and out-of-hours clinics. Based on my observations and what patients, dentists and dental nurses later told me by telephone, I produced a list of factors associated with treatment decisions. Next, people with experience of receiving urgent dental care, dental team members and NHS managers worked together to prioritise factors for my future work. Finally, using behavioural science (the Theoretical Domains Framework and the Theory&Techniques of Behaviour ChangeTool), I designed tools aimed at reducing antibiotic prescribing by tackling these priority factors.
Results: The bundle of interventions developed included two new communication and engagement tools. One was for use before and during urgent dental appointments, the other was a drama-based tool for engaging a wider audience. Because ‘antibiotic beliefs’ was the only factor found to influence dentists and patients and dental nurses, providing ‘information about consequences’ (a known way to address behaviours driven by 'beliefs and consequences') was at the heart of the communication and engagement tools developed. A selection of other priority factors identified during the research were also included in the intervention design.
Conclusions: To slow the spread of antibiotic resistant infections, clinicians are encouraged to use antibiotics only when necessary. Two evidence-based, theory-informed behaviour change interventions have been developed to complement tools already within the UK dental antimicrobial stewardship toolkit.
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