International Delphi Study to Optimize the Oral Health Section in interRAI

Abstract

Introduction: The oral health (OH) of care-dependent older people is generally poor. Since caregivers are mainly responsible for older people’s daily care, they can be considered important intermediaries to improve their OH by performing regular OH assessments. The interRAI instruments are introduced in 37 countries to assess care needs and facilitate care planning across different health care settings. The oral health section (OHS) within the interRAI instrument used in long-term care facilities was optimized for the Belgian context to identify residents who need assistance with daily oral care and/or need to be referred to a dentist. This Delphi study evaluated whether the OHS is also relevant and useful in other countries and modified the OHS accordingly until an international consensus was reached. Participants were experts in OH for older people. During 2 rounds of online questionnaires, experts rated the content, assessment process, triggering of Clinical Assessment Protocols, and accompanying guidelines and instruction videos of the optimized OHS. Based on the experts’ comments and suggestions collected during the first round, the OHS was adjusted and presented to the experts in the second round for re-evaluation. The first and second questionnaires were completed by 48 and 42 oral health experts from 29 and 27 countries where the interRAI instruments are introduced, respectively. Five experts from 5 countries where interRAI is not introduced also participated in both rounds. After the second round, a consensus of over 86% was reached on all criteria. International consensus on the OHS was reached, considering national and cultural differences that may affect OH. The next step in this research is to evaluate the assessment process to identify potential barriers and facilitators to achieving reliable OH assessments internationally. Furthermore, the effect of the OHS at the level of the resident and of the caregivers will be evaluated.

Comparison of the oral health status of nursing home residents using the current and the newly developed interRAI Oral Health Section (OHS-interRAI): a cross-sectional study

“…Reasons for this may include lack of knowledge and experience (15,18). As a result, an e-learning with comprehensive information, including practical examples and attention to residents with cognitive di culties, was recently developed to help caregivers identify oral health problems with the OHS-interRAI (22).…”

“…Assessment of the other six items requires inspection of the mouth. Photographs with labels and indications of relevant structures and abnormalities are available to assist caregivers in identifying oral health problems (18,22). In addition, general and speci c utilization guidelines are available, as well as instruction videos with comprehensive information for each item (22).…”

“…Recently, the ohr-interRAI was further optimized and re ned by a group of 53 international experts in oral health of older persons, resulting in the interRAI Oral Health Section (OHS-interRAI) (22). This version differs from the ohr-interRAI through textual adjustments and additional clarifying information about the items, as well as better visualizations and labelling of relevant structures and abnormalities in the photographs (22).…”

Aging and Oral Health: Biological and Sociobehavioral Perspectives

“…The authors issue a call to action for progress on oral health in older populations through care model and electronic health record innovations, education, policy changes, and outcome-driven research. In this context, Schoebrechts et al (2023) performed an international consensus study to validate previously optimized guidelines in oral health care as a section of the interRAI assessment system. By applying a Delphi approach with experts from 34 countries, a consensus was reached on all criteria used to provide caregivers with assistance regarding daily oral care and/or the need of referral to a dentist of care-dependent older individuals.…”

Nursing home residents’ perspectives on oral health: An in-depth interview study

“…Even though there are multiple barriers ( De Visschere et al, 2015 ; Chan et al, 2023 ; Harnagea et al, 2017 ; Niesten et al, 2021a ; Niesten et al, 2021b ), it is important to integrate oral care into general care planning. In order to improve oral care for care-dependent older people, the Oral Health Section for use within the interRAI Suite of instruments (OHS-interRAI) was developed and optimised for use by caregivers ( Krausch-Hofmann et al, 2021 ; Schoebrechts et al, 2023 ). The interRAI Suite comprises instruments for various care settings that measure key areas of physical and cognitive functioning, mental and physical health, social support and service use.…”