gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Impact of national guidance for drug prescribing for dentistry

Meeting Abstract

  • S. Rutherford - Scottish Dental Clinical Effectiveness Programme, University of Dundee, Dundee, UK
  • J. Clarkson - Scottish Dental Clinical Effectiveness Programme, University of Dundee, Dundee, UK
  • D. Stirling - Health Services Research Unit, University of Aberdeen, Aberdeen, UK
  • L. Young - Scottish Dental Clinical Effectiveness Programme, NHS Education for Scotland, Dundee, UK
  • P. Elouafkaoui - Scottish Dental Clinical Effectiveness Programme, University of Dundee, Dundee, UK
  • A. Templeton - Scottish Dental Clinical Effectiveness Programme, University of Dundee, Dundee, UK
  • C. Ramsay - Health Services Research Unit, University of Aberdeen, Aberdeen, UK
  • Methodology Group TRiaDS

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO78

DOI: 10.3205/12gin110, URN: urn:nbn:de:0183-12gin1102

Published: July 10, 2012

© 2012 Rutherford et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Guidance for prescribing in dentistry was first published in 2008 in response to concerns about inappropriate prescribing of antibiotics. Publication coincided and included recommendations in NICE guidance for prophylactic prescribing of 3g amoxillin for infective endocarditis.

Objectives: To monitor target drugs, to assess the impact of guidance and to inform the need for and design of implementation strategies.

Methods: Routine data on prescribing by all individual dentists in Scotland were monitored, analysed and trends identified.

Results: The trend in routine data represent a reduction of 70% in the prescribing of 3g amoxicillin within three months following the publication of national guidance. There has been no further reduction and approximately 400 prescriptions are fulfilled each month. Total antibiotic prescribing by dentists, which accounts for around 10% of all primary care antibiotic prescribing, is steadily increasing.

Discussion: While the prescribing of prophylactic antibiotics has fallen significantly, the publication of guidance alone has not reduced total antibiotic prescribing by dentists. With increasing use of warfarin and statins, concerns about possible harmful co-prescribing are heightened. This work has informed the development of a multifaceted implementation strategy, including a prescribing smartphone app that gives ready access to interaction information.

Implications for guideline developers/users: Monitoring of routine data can be an invaluable tool to support guidance implementation.