Abstract
ObjectiveTo 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).MethodsA 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.ResultsThe 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.ConclusionIn the context of collaborative, multi-disciplinary 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.
Highlights
The provision of preventive oral healthcare advice has traditionally been the preserve of dental health professionals; a situation that has been established over the years as a result of the differing training, clinical practice and healthcare delivery systems that exist between dental care and other aspects of healthcare
In this paper we present a critical synthesis of these five previously published papers, which substantively integrates the findings of the published work
This was undertaken via a theoretical lens which was conceptually appropriate to the context of care, the Rainbow Model for Integrated Care.[18]
Summary
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). 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. There is a lack of published literature on the role of pharmacists in relation to the oral health-related adverse effects of medications One such condition is medication-related osteonecrosis of the jaw (MRONJ), which represents a significant adverse effect of a range of anti-resorptive and anti-angiogenic drugs, such as the bisphosphonates and denosumab. The original raw data in the form of verbatim transcripts were collectively revisited and reanalysed via the theoretical lens of
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