Impact of participation in a PBRN on evidence-based treatment [presentation] Presentation uri icon

abstract

  • Objective: Practice-based research networks (PBRN) have the potential to generate findings immediately relevant to practitioners and expedite translation of research into practice. This project utilized clinical data from electronic heath records to measure the impact of practitioner participation in the National Dental PBRN. Method: Multivariate logistic regression models adjusting for clustering at the clinic, provider, and patient level compared restoration rates from 2005-2008 for 35 providers. Data came from two sources: electronic dental records and a provider database. All new F80, F81, and F82 early caries findings and any co-occurring caries found during an examination visit were identified. Treatment was determined by codes occurring up to six-months following the initial finding date and was categorized as: Fluoride, Remineralization, or Restoration. Each provider’s level of PBRN engagement determined by study involvement and meeting attendance was tracked in a database maintained by the study coordinator. Result: In 2005, overall restoration rates were high (79.5%). Their use decreased by 5.12% in 2008 to 74.3% (p=.15). Use of, and changes in, restoration rates differed significantly according to PBRN involvement. Providers with high PBRN involvement (N=14) decreased use of restorations by 15.4% from 76.6% in 2005 to 63.3% in 2008 (p<.01). Providers with no PBRN involvement (N=6) decreased their use of restorations by only 7.5% (88.3% to 81.67%; p=.041). Comparatively, providers with high PBRN involvement were 15.15% less likely to use restorations in 2005 (76.9% versus 88.3%; p<.01), and had a significantly larger decrease in restoration use from 2005 to 2008 (p<.01). Conclusion: Multiple factors impact the decision to restore or remineralize a tooth with a carious lesion. Enrollment in the National Dental PBRN is correlated with practice change defined as significant decreases in restoration rates. The impact is most significant for providers most involved in relevant study and dissemination activities.