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Effect evaluation of a supervised versus non‐supervised implementation of an oral health care guideline in nursing homes: a cluster randomised controlled clinical trial
Author(s) -
De Visschere Luc,
Schols Jos,
van der Putten GertJan,
de Baat Cees,
Vanobbergen Jacques
Publication year - 2012
Publication title -
gerodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 54
eISSN - 1741-2358
pISSN - 0734-0664
DOI - 10.1111/j.1741-2358.2010.00418.x
Subject(s) - medicine , guideline , oral hygiene , randomized controlled trial , intervention (counseling) , hygiene , health care , family medicine , nursing , physical therapy , dentistry , surgery , pathology , economics , economic growth
doi: 10.1111/j.1741‐2358.2010.00418.x
Effect evaluation of a supervised versus non‐supervised implementation of an oral health care guideline in nursing homes: a cluster randomised controlled clinical trial Objective: To compare a supervised versus a non‐supervised implementation of an oral health care guideline in Flanders (Belgium). Background: The key factor in realising good oral health is daily oral hygiene care. In 2007, the Dutch guideline ‘Oral health care in care homes for elderly people’ was developed to improve oral health of institutionalised elderly. Materials and Methods: A random sample of 12 nursing homes was randomly allocated to the intervention or the control group. Representative samples of 30 residents in each home were monitored during a 6‐month study period. The intervention included a supervised implementation of the guideline. Results: At the 6‐month follow‐up, only a small but statistically significant ( p = 0.002) beneficial effect (0.32) of the intervention was observed for denture plaque after adjustment for baseline value and the random effect of the institution. In the linear mixed regression models, including a random institution effect, difference in denture plaque level was no longer statistically significant at the 5% level. Conclusion: Only denture hygiene has been improved by the supervised implementation, although with lower benefits than presumed. Factors on institutional level, difficult to assess quantitatively, may play an important role in the final result.