■人乳头瘤病毒(HPV)免疫可以预防癌症,但摄取一直不完整(随着COVID-19大流行,情况更糟)。牙科临床医生已经筛查口腔癌,其中许多是由HPV引起的,可以确定疫苗接种候选者,但这需要一个案例调查策略。
■这项研究的目的是(1)开发和测试一种病例发现方法,以识别HPV疫苗的候选患者,(2)检测HPV疫苗的干预,由牙科专业人员对疫苗的摄取。
■设计:前瞻性,非随机可行性病例发现研究,在一般牙科诊所进行为期4周的入组期和为期6周的随访期.地点:埃德蒙顿的两个普通和非商业牙科办公室,加拿大艾伯塔省。受试者:符合加拿大卫生部HPV疫苗接种标准的连续计划(非紧急)患者:9-45岁的具有免疫能力的男性和女性以及免疫功能低下的患者。从每个受试者或父母获得对讨论的同意。干预:符合纳入标准的预定牙科患者由研究助理标记,该研究助理每周审查预约时间表,为期4周。对于这些主题,牙科临床医生(牙医和牙科卫生师)使用我们的牙科对话工具讨论HPV疫苗接种并回答问题.同意接受HPV疫苗的参与患者由主治牙医处方,并被指示与当地药房进行随访以接种疫苗。在6周后接触每个提供HPV处方的参与者,以确定他们是否接受了第一剂疫苗。结果:我们的病例发现策略的产量以及在疫苗处方后6周内患者的首次HPV疫苗剂量的接收。
■我们的病例发现策略在4周内评估了656名计划患者。从这次筛选来看,179(病例发现率为20.4%),是HPV疫苗讨论的候选人。这179名患者中有43名(24%)已经接种了疫苗。.两名患者(1.1%)不同意与之交谈,134(74.8%)同意HPV疫苗的讨论。.在与牙科临床医生交谈后,134名患者中有48名(35.8%)接受了牙医的处方。最终,8/48(16%)(患者在随访6周之前接受了第一剂HPV疫苗。然而,在同意讨论HPV癌症和牙医接种疫苗的患者中,这仅为4.5%(8/177).
我们证明了在一般牙科诊所发现HPV疫苗候选的病例是可行的,合理的产量。虽然牙科对话工具被描述为解释事实和回答问题的绝佳资源,极少数患者在随访6周后接种疫苗.需要进一步的工作来加强干预,可能包括与牙科临床医生的后续讨论。
UNASSIGNED: Human papillomavirus (HPV) immunization can prevent cancers, but uptake has been incomplete (and worse with the COVID-19 pandemic). Dental clinicians already screen for oral cancers, many of which are caused by HPV, and could identify vaccination candidates, but this requires a case-finding strategy.
UNASSIGNED: The purpose of this study was (1) to develop and test a
case-finding approach to identify patients who were candidates for HPV vaccinations, (2) to test an HPV vaccination intervention by dental professionals on vaccination uptake.
UNASSIGNED: Design: Prospective, non-randomized feasibility
case finding study with a 4-week enrollment period and a 6 week follow up period in general dental offices.Setting: Two general and non-commercial dentistry offices in Edmonton, Alberta Canada.Subjects: Consecutive scheduled (non-emergent) patients who met the Health Canada criteria for HPV vaccination: immunocompetent males and females aged 9-45 years and those who are immunocompromised. Consent for the discussion was obtained from each subject or parent.Intervention: Scheduled dental patients meeting the inclusion criteria were flagged by a research assistant who reviewed the appointment schedule each week for 4 weeks. For these subjects, dental clinicians (dentists and dental hygienists) used our Dental Dialogue Tool to discuss HPV vaccination and answer questions. Participating patients who consented to receive the HPV vaccine were given a prescription by the attending dentist and were directed to follow-up with a local pharmacy to have the vaccine administered. Each participant that was provided with an HPV prescription was contacted after 6 weeks to identify if they received the first dose of vaccine.Outcomes: Yield of our case-finding strategy and receipt of a patient\'s first HPV vaccine dose during 6 weeks post vaccine prescription.
UNASSIGNED: Our
case-finding strategy assessed 656 scheduled patients over 4 weeks. From this screening,179 (a
case-finding yield of 20.4 %), were candidates for HPV vaccine discussion. Forty-three of these 179 patients (24 %) were already vaccinated.. Two patients (1.1 %) did not consent to be spoken with and 134 (74.8 %) consented to the HPV vaccine discussion.. Forty-eight of 134 patients (35.8 %) of patients accepted a prescription from the dentist after speaking with the dental clinician. Ultimately, 8/48 (16 %) (patients received their first dose of the HPV vaccine by the 6 week of follow-up call. However, this is only 4.5 % (8/177) of those patients who did consent for the discussion of HPV cancers and vaccination from their dentist.
UNASSIGNED: We demonstrated that
case-finding for HPV vaccine candidates in general dental offices was feasible, with a reasonable yield. While the dental dialogue tool was described as a great resource to explain the facts and answer questions, very few patients were vaccinated after 6 weeks of follow-up. Further work is necessary to sharpen the intervention, perhaps including follow-up discussions with the dental clinicians.