Comparing how patients value and respond to information on risk given in three different forms during dental check-ups: the PREFER randomised controlled trial

Harris, R ORCID: 0000-0002-5891-6826, Lowers, V ORCID: 0000-0002-5996-9735, Laverty, L ORCID: 0000-0002-8491-8171, Vernazza, C, Burnside, G ORCID: 0000-0001-7398-1346, Brown, S ORCID: 0000-0002-6142-0995 and Ternent, L (2020) Comparing how patients value and respond to information on risk given in three different forms during dental check-ups: the PREFER randomised controlled trial. TRIALS, 21 (1). 21-.

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Official URL: http://dx.doi.org/10.1186/s13063-019-3824-3

Abstract

<h4>Background</h4>This study aims to compare patient preference for, and subsequent change in, oral health behaviour for three forms of risk information given at dental check-ups (verbal advice compared to verbal advice accompanied by a traffic light (TL) risk card; or compared to verbal advice with a quantitative light fluorescence (QLF) photograph of the patient's mouth).<h4>Methods</h4>A multi-centre, parallel-group, patient-randomised clinical trial was undertaken between August 2015 and September 2016. Computer-generated random numbers using block stratification allocated patients to three arms. The setting was four English NHS dental practices. Participants were 412 dentate adults at medium/high risk of poor oral health. Patients rated preference and willingness to pay (WTP) for the three types of information. The primary outcome was WTP. After receiving their check-up, patients received the type of information according to their group allocation. Follow-up was by telephone/e-mail at 6 and 12 months. Mean and median WTP for the three arms were compared using Wilcoxon signed-rank tests. Tobit regression models were used to investigate factors affecting WTP and preference for information type. Secondary outcomes included self-rated oral health and change in oral health behaviours (tooth-brushing, sugar consumption and smoking) and were investigated using multivariate generalised linear mixed models.<h4>Results</h4>A total of 412 patients were randomised (138 to verbal, 134 to TL and 140 to QLF); 391 revisited their WTP scores after the check-up (23 withdrew). Follow-up data were obtained for 185 (46%) participants at 6 months and 153 (38%) participants at 12 months. Verbal advice was the first preference for 51% (209 participants), QLF for 35% (145 participants) and TL for 14% (58 participants). TL information was valued lower than either verbal or QLF information (p < 0.0001). Practice attended was predictive of verbal as first preference, and being older. Practice attended, preferring TL the most and having fewer than 20 teeth were associated with increased WTP; and living in a relatively deprived area or having low literacy decreased WTP. There were no significant differences in behaviour change on follow-up.<h4>Conclusions</h4>Although a new NHS dental contract based on TL risk stratification is being tested, patients prefer the usual verbal advice. There was also a practice effect which will needs to be considered for successful implementation of this government policy.<h4>Trial registration</h4>ISRCTN, ISRCTN71242343. Retrospectively registered on 27 March 2018.

Item Type:	Article
Uncontrolled Keywords:	Risk, Communication, Oral health, Health education, Behaviour change, Dental practice
Depositing User:	Symplectic Admin
Date Deposited:	13 Jan 2020 10:41
Last Modified:	19 Jan 2023 00:10
DOI:	10.1186/s13063-019-3824-3
Open Access URL:	https://doi.org/10.1186/s13063-019-3824-3
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3070447