Improving the 'Implications for practice/research' section of a Cochrane Review using a survey questionnaire

Article type
Authors
Agnihotry A1, Al Langawi J2, Fedorowicz Z2, Outhouse T2
1Cochrane Oral Health Group, India
2Bahrain Cochrane Branch, Bahrain
Abstract
Background:
Irreversible pulpitis, characterized by acute and intense pain, is one of the most frequent reasons patients attend for emergency dental care. Apart from tooth removal, pain relief is achieved by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the root canal. However, although many dentists continue to prescribe systemic antibiotics for irreversible pulpitis, our Cochrane Review (CD 004969) found that there was no evidence for their effectiveness.

Objectives:
To use the results of our Cochrane Review on the lack of effectiveness of antibiotics for irreversible pulpitis to design a survey that can be used to help inform the 'Implications for practice/research' sections of Cochrane Reviews.

Methods:
On-line survey: clinical vignette, single question with a choice of one of six treatment options, one of which indicates a preference for prescribing of antibiotics for irreversible pulpitis. Participants surveyed were a global sample of general dentists, specialist endodontists and post-doctoral endodontic residents. The survey was distributed via email, online professional public forums and social networks. Responses were imported into Excel and analyzed.
Further ongoing analysis will explore survey responders’ awareness of the Cochrane Review CD 004969 and any related clinical guidelines.

Results:
Two-hundred and fifty-five (255) completed questionnaires (March 2014). Responders: general dentists (205); specialist endodontists (32); post-doctoral residents (18). Country of origin: 15 countries across the globe. Sixty-four (25%) would prescribe antibiotic for irreversible pulpitis; 86% of those would prescribe antibiotics plus analgesics, the remainder (nine) antibiotics alone.

Conclusions:
Antibiotics continue to be prescribed for irreversible pulpitis by some general dentists and endodontists at global level. This survey provided additional contextual information which has been discussed and included in the 'Implications for research/practice' section of our Cochrane Review.