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Cited by 16Clinical practice guidelines implementationHealth Sciences Research and EducationDental Education, Practice, Research

Practice change toward better adherence to evidence-based treatment of early dental decay in the National Dental PBRN

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National Dental PBRN Collaborative Group, Rindal, Donald Brad, Flottemesch, Thomas J, Durand, Emily U, Godlevsky, Olga V, Schmidt, Andrew M, Gilbert, Gregg H·2014·Implementation Science
DOI 10.1186/s13012-014-0177-xPMC PMC4260248
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Abstract

BACKGROUND: Significant national investments have aided the development of practice-based research networks (PBRNs) in both medicine and dentistry. Little evidence has examined the translational impact of these efforts and whether PBRN involvement corresponds to better adoption of best available evidence. This study addresses that gap in knowledge and examines changes in early dental decay among PBRN participants and non-participants with access to the same evidence-based guideline. This study examines the following questions regarding PBRN participation: are practice patterns of providers with PBRN engagement in greater concordance with current evidence? Does provider participation in a PBRNs increase concordance with current evidence? Do providers who participate in PBRN activities disseminate knowledge to their colleagues? METHODS: Logistic regression models adjusting for clustering at the clinic and provider levels compared restoration (dental fillings) rates from 2005-2011 among 35 providers in a large staff model practice. All new codes for early-stage caries (dental decay) and co-occurring caries were identified. Treatment was determined by codes occurring up to 6 months following the date of diagnosis. Provider PBRN engagement was determined by study involvement and meeting attendance. RESULTS: In 2005, restoration rates were high (79.5%), decreased to 47.6% by 2011 (p < .01), and differed by level of PBRN engagement. In 2005, engaged providers were less likely to use restorations compared to the unengaged (73.1% versus 88.2%; p < .01). Providers with high PBRN involvement decreased use of restorations by 15.4% from 2005 to 2008 (2005: 73%, 2008: 63%; p < .01). Providers with no PBRN involvement decreased use by only 7.5% (2005: 88%, 2008: 82%; p = .041). During the latter half of 2008 following the May PBRN meeting, attendees reduced restorations by 7.5%, compared to a 2.4% among non-attendees (OR = .64, p < .01). CONCLUSIONS: Based on actual clinical data, PBRN engagement was associated with practice change consistent with current evidence on treatment of early dental decay. The impact of PBRN engagement was most significant for the most-engaged providers and consistent with a spillover effect onto same-clinic providers who were not PBRN-engaged. PBRNs can generate relevant evidence and expedite translation into practice.

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  • Impact on everyday practice can be the key research question for some studies, although the typical goal is to contribute to the evidence base in a manner similar to individual "R01" studies or clinical trials.

    “Impact on everyday practice can be the key research question for some studies [30-32], although the typical goal is to contribute to the evidence base in a manner similar to individual “R01” studies or clinical trials.”

    From Structure, function, and productivity from the National Dental Practice-Based Research Network. (2022) · cites this paper as [31]

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Sorted by citations

Authors
National Dental PBRN Collaborative Group, Rindal, D. B., Flottemesch, T. J., Durand, E. U., Godlevsky, O. V., Schmidt, A. M., & Gilbert, G. H.
Affiliations
  • HealthPartners (US)
  • University of Alabama at Birmingham (US)
Corresponding author
Rindal, Donald Brad
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2014-12
Volume
9
Issue
1
Pages
177-177
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/s13012-014-0177-x
PMC
PMC4260248
OpenAlex
W2128398339
Cited by
16
References
3
Citations by year
2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 1 · 2016: 1 · 2015: 2
FWCI
1.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (DE-22516, DE-16746)
  • National Institute of Dental and Craniofacial Research (U01-DE-16746, R03-DE-22089, U01DE016746, R03DE022089, U19-DE-22516, U01‐DE‐16747, U01DE016747, U19DE022516)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Health Sciences › Health Professions › General Health Professions › Dental Education, Practice, Research
Keywords
practice-based research networks, caries treatment, evidence-based practice, guideline adherence, dental restorations, practice change, translational research, knowledge dissemination, provider engagement, clinical practice patterns, pit and fissure sealants, fluoride varnish, oral health disparities
MeSH terms
Attitude of Health Personnel, Dental Caries, Humans, Regression Analysis, Retrospective Studies, Practice Patterns, Dentists', Guideline Adherence, Evidence-Based Dentistry, Community-Based Participatory Research

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