A qualitative study of patients' knowledge and views of about oral health and acceptability of related intervention in an Australian inpatient alcohol and drug treatment facility

Abstract

Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare; most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.

Oral health‐care needs among clients receiving alcohol and other drugs treatment—A scoping review

“…In the first focus area, 23 studies were identified that included 3611 participants with a mean age ranging from 27.9 to 44 years [ 19 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. The studies were conducted in Australia ( n = 2), Brazil ( n = 3), India ( n = 2), Indonesia ( n = 1), Iran ( n = 1), Ireland ( n = 2), Italy ( n = 2), Lithuania ( n = 1), Norway ( n = 1), Portugal ( n = 1), Serbia ( n = 1), South Africa ( n = 1), United Kingdom ( n = 1) and the United States ( n = 4).…”

Systematic review of guidelines for managing physical health during treatment for substance use disorders: Implications for the alcohol and other drug workforce

“…A more universal approach to recommendations related to oral health, tobacco use, physical inactivity and dietary habits during AOD treatment should be considered. The irregularity in which these health behaviours were mentioned in guidelines was an unexpected finding of the review, particularly given literature reporting on the way that AOD services are well‐placed to deliver healthy lifestyle interventions [9, 11, 92–95].…”

Acceptability of the Direct Health Facility Financing (DHFF) initiative in Tanzania: A mixed methods process evaluation of the moderating factors

“…Capacity building for implementation teams on the components of the program and the implementation processes has been reported to be a cornerstone of acceptability. 43,44 The fact that participants who felt capable of implementing the program and its associated processes were more likely to accept the program highlights the importance of imparting necessary skills to the implementers. Constructs related to 'feeling capable', such as perceived behaviour control 45 and self-control, 46 have been linked to actual performance of the respective behaviours.…”

“…The finding that knowledge about the program was associated with acceptability is not surprising, but further underscores the importance of equipping implementers with relevant knowledge about the program. Capacity building for implementation teams on the components of the program and the implementation processes has been reported to be a cornerstone of acceptability 43,44 …”