A critical synthesis of the role of the pharmacist in oral healthcare and management of medication-related osteonecrosis of the jaw

Abstract

To consolidate extant published evidence in relation to the potential of integrating oral healthcare for patients at risk of developing medication-related osteonecrosis of the jaw (MRONJ). METHODS: A critical synthesis and consolidation of five publications was undertaken. As a mechanism of situating the extant work within the context of primary healthcare provision, the Rainbow Model of Integrated Care was applied as a theoretical lens through which the conceptual findings could be collectively applied to practice. RESULTS: The critical synthesis revealed a thematic emergence relating to both formative and normative integration. The most salient of these were the identification of limited shared clinical records, and disconnection of oral healthcare provision from patients' general medical care. The three levels of the Rainbow Model of Integrated Care reflected a series of issues for address. CONCLUSION: In the context of collaborative, multidisciplinary working for patients at risk of development of MRONJ, pharmacists are a professional group which this research reveals to be an underutilised resource. Reduction of oral health inequality at all levels of patient care is a key priority and this research highlights areas for address in relation to requirements for interprofessional education, optimal communication and policies reflective and facilitative of these.

Qualitative interview study exploring the early identification and referral of patients with suspected head and neck cancer by community pharmacists in England

“…However, our study found limited communication and referral pathways between dental, medical and pharmacy services, alongside participants reporting significant challenges in getting patients to access and engage with dentists. This is further supported by existing literature that highlights the lack of integration of dental teams within other NHS services 21 22…”

Interprofessional learning for dental and pharmacy professionals: learning together changes how you work together

“…One study by Sturrock et al, exploring dental professionals' attitudes towards MRONJ and current multidisciplinary team approaches to care, showed that dental professionals felt there was little collaboration between themselves and pharmacists and general communication was around prescribing errors and drug interactions. 14 The study also showed dental professionals were willing to engage with other healthcare professionals to improve patient care. In particular, better communication with pharmacists was considered to be beneficial to dental professionals.…”

Assessment of Oral Health Knowledge of Pharmacists in Two Tertiary Hospitals in Enugu, Nigeria

“…[ 8 ] In developing countries like Nigeria, individuals with ill health, especially dental diseases, first consult the pharmacist to seek dental advice and procure drugs from them before visiting the dental clinic. [ 19 ] More corroboration between dentists and pharmacists to improve the oral health knowledge of pharmacists is recommended. The pharmacy undergraduate curriculum can be modified to accommodate some dental topics in the course of training.…”

“…[ 13 , 16 ] Some of the barriers to the production of leaflets, pamphlets, and posters on oral health, in addition to seminars and oral health care training[ 16-18 ] are some of the preferred choices for improving oral health knowledge among pharmacists. An interdisciplinary approach that includes pharmacists in the management of dental conditions[ 19 ] has also been suggested.…”