An initial, qualitative investigation of patient-centered education in dentistry.

Patient education plays an important role in the delivery of dental care. Current evidence suggests that the emergence of the Internet and other electronic resources are significantly influencing how patients learn about their healthcare. We conducted a qualitative inquiry using a combination of interviews with patients and clinicians, and direct observation of patient education episodes, to begin identifying requirements for customized, patient-centered approaches to education at the point of care. Most patients in our study felt comfortable with the amount and method of education during the dental visit, but 38% sought additional information on the Internet. Dentists and their team members provided patient education mostly verbally, supported by media such as radiographs, images and models. Electronic means, especially the Internet, were little used. Patient education occupied a significant portion of the time of initial comprehensive examination (29%) and routine (7%) dental visits. A deeper understanding of patient knowledge deficits and information needs will be needed to design effective educational interventions. Patient education should be meaningfully integrated into the workflow shared by dentists, their team members and patients, in order to maximize its outcomes.

Inhibitory metabolic drug interactions with newer psychotropic drugs: inclusion in package inserts and influences of concurrence in drug interaction screening software.

BACKGROUND: Food and Drug Administration (FDA) regulations mandate that package inserts (PIs) include observed or predicted clinically significant drug-drug interactions (DDIs), as well as the results of pharmacokinetic studies that establish the absence of effect. OBJECTIVE: To quantify how frequently observed metabolic inhibition DDIs affecting US-marketed psychotropics are present in FDA-approved PIs and what influence the source of DDI information has on agreement between 3 DDI screening programs. METHODS: The scientific literature and PIs were reviewed to determine all drug pairs for which there was rigorous evidence of a metabolic inhibition interaction or noninteraction. The DDIs were tabulated noting the source of evidence and the strength of agreement over chance. Descriptive statistics were used to examine the influence of source of DDI information on agreement among 3 DDI screening tools. Logistic regression was used to assess the influence of drug class, indication, generic status, regulatory approval date, and magnitude of effect on agreement between the literature and PI as well as agreement among the DDI screening tools. RESULTS: Thirty percent (13/44) of the metabolic inhibition DDIs affecting newer psychotropics were not mentioned in PIs. Drug class, indication, regulatory approval date, generic status, or magnitude of effect did not appear to be associated with more complete DDI information in PIs. DDIs found exclusively in PIs were 3.25 times more likely to be agreed upon by all 3 DDI screening tools than were those found exclusively in the literature. Generic status was inversely associated with agreement among the DDI screening tools (odds ratio 0.11; 95% CI 0.01 to 0.89). CONCLUSIONS: The presence in PIs of DDI information for newer psychotropics appears to have a strong influence on agreement among DDI screening tools. Users of DDI screening software should consult more than 1 source when considering interactions involving generic psychotropics.