Health Care Guidelines Research Articles

Interventions to prevent post-tuberculosis sequelae: a systematic review and meta-analysis

Tuberculosis (TB) remains a global public health challenge, causing substantial mortality and morbidity. While TB treatment has made significant progress, it often leaves survivors with post-TB sequelae, resulting in long-term health issues. Current healthcare systems and guidelines lack comprehensive strategies to address post-TB sequelae, primarily due to insufficient evidence. This systematic review and meta-analysis aimed to identify effective interventions for preventing post-TB sequelae. A systematic search was conducted across four databases including PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials from inception to September 22, 2023. Eligible studies reported interventions designed to prevent post-TB sequelae were included. A random effect meta-analysis was conducted where applicable, and heterogeneity between studies was evaluated visually using forest plots and quantitatively using an index of heterogeneity (I2). This study is registered with PROSPERO (CRD42023464392). From the 2525 unique records screened, 25 studies involving 10,592 participants were included. Different interventions were evaluated for different outcomes. However, only a few interventions were effective in preventing post-TB sequelae. Rehabilitation programs significantly improved lung function (Hedges's g=0.21; 95% confidence interval (CI): 0.03, 0.39) and prevented neurological sequelae (relative risk (RR)=0.10; 95% CI: 0.02, 0.42). Comprehensive interventions and cognitive-behavioural therapy significantly reduced the risk of mental health disorders among TB survivors (Hedges's g=-1.89; 95% CI:-3.77,-0.01). In contrast, interventions targeting post-TB liver sequelae, such as vitamin A and vitamin D supplementation and hepatoprotective agents, did not show significant reductions in sequelae (RR=0.90; 95% CI: 0.52, 1.57). Moreover, adjunctive therapies did not show a significant effect in preventing post-TB neurological sequelae (RR=0.62, 95% CI: 0.31, 1.24). Rehabilitation programs prevented post-TB lung, neurologic and mental health sequelae, while adjuvant therapies and other interventions require further investigation. Healy Medical Research Raine Foundation, Curtin School of Population Health and the Australian National Health and Medical Research Council.

Caring for Undocumented Migrants: Significance of Recognition and Respect during Healthcare Encounters

Undocumented migrants are often in a position of extreme vulnerability and experience many barriers to accessing mental health care. It is crucial that health professionals understand this and quickly establish trust and respect. If the stressful living conditions that contribute to the distress of undocumented migrants are recognized, compassionate and trauma-informed care is enhanced. In this regard, it is important that health professionals understand the fear of being expelled from a country. This paper discusses problems that arise when health professionals interact with undocumented migrants and the need to quickly convey recognition to establish trust and respect. We argue that insights from Axel Honneth’s social philosophical theory of recognition and disrespect can further enhance health professionals strategies to improve their verbal and non-verbal communication and thereby increase access to health care for undocumented migrants. We suggest ideas for codifying this knowledge in health care policies and guidelines.

Utilizing the Biopsychosocial Approach for Understanding and Treating Pain

The biomedical model's narrow focus on structural causes is inadequate for chronic pain, which involves complex, multifactorial issues beyond tissue damage. Chronic pain affects nearly 21% of U.S. adults, underscoring the urgent need for a deeper understanding of pain among rehabilitation clinicians. The biopsychosocial (BPS) model broadens this perspective by considering psychological and social factors, such as emotional distress and lifestyle impacts, alongside physical aspects. Despite the effectiveness of combining exercise with BPS education in treating chronic pain, current educational and clinical practices have yet to fully embrace this comprehensive approach. Future research should prioritize incorporating BPS principles into healthcare education and clinical guidelines to improve treatment outcomes and address the significant effects of chronic pain on individuals' quality of life, healthcare engagement, and daily activities.

Implementing Clinical Guidelines for the Treatment of Psychosis: The Frontline Leaders' Point of View. A Qualitative Study.

Despite the large amount of leadership and implementation theories and recommendations, healthcare services continue to struggle with efficiently incorporating new knowledge. The questioning of conventional leadership approaches in healthcare organizations prompted us to investigate how frontline leaders comprehend their own implementation intentions and actions, and how these intentions and actions may impact the implementation of clinical guidelines in mental healthcare in Norway. Employing a theory-driven qualitative design, we conducted nine semi-structured interviews with frontline leaders who had recently led implementation of clinical guidelines for the treatment of psychosis in mental health. We employed Systematic Text Condensation, informed by Normalization Process Theory, to structure and analyze the data and used fidelity scales to measure the degree of implementation and distinguish between leaders' levels of success in implementation. Frontline leaders in units that achieved high success in implementation described their intentions and actions differently, from those with less success. The former group's actions aligned more closely with the constructs of the Normalization Process Theory compared to the latter group when describing their actions. Frontline leaders leading units with a high degree of implementation success describe relation-orientation, trust, and providing adaptive space for staff members to take initiative. In contrast, those leading units with less implementation success describe more control and guidance of co-operators and place more emphasize on information and knowledge. Differences in how frontline leaders describe their actions and intentions to achieve clinical guideline implementation suggest that the leadership approach of these frontline leaders is an important factor to consider when planning and conducting implementation. To better understand the implementation process, it is important to pay attention to how frontline leaders customize their leadership approaches to the dynamics of complex organizations, and how they interact with their team and superiors.

Acceptance of mobile application-based clinical guidelines among health professionals in Northwestern Ethiopia: A mixed-methods study.

Globally, healthcare providers have faced significant difficulties in adhering to clinical guidelines. Applying mobile health systems is a crucial strategy for enhancing the dissemination and accessibility of clinical guidelines. This study aimed to assess the acceptance of mobile app-based primary healthcare clinical guidelines and associated factors among health professionals in central Gondar health centers. A cross-sectional study supplemented with qualitative data was conducted on 403 health workers. Data were collected using a pre-test structured printed questionnaire and entered into EpiData version 4.6. Analysis was conducted using Stata version 14, which included bivariable and multivariable logistic regression analyses. For qualitative data, thematic analysis was conducted using Open Code v.4.2. Approximately 28% (95% confidence interval (CI): 23%-32%) of health professionals had utilized mobile app-based clinical guidelines. The availability of IT support (adjusted odds ratio (AOR) = 3.51, 95% CI: 1.82-6.78), good knowledge (AOR = 3.46, 95% CI: 1.5-6.78), perceived usefulness (AOR = 2.21, 95% CI: 1.00-4.99), m-Health app exposure (AOR = 2.34, 95% CI: 1.2-4.50), and ease of use (AOR = 5.77, 95% CI: 2.50-13.32) were significantly associated with the acceptance of the mobile app-based clinical guideline. In qualitative data, lack of training and supervision and access to smartphones were barriers to acceptance of the mobile app-based clinical guideline. In summary, acceptance of the app is currently low. However, it can be increased by improving the availability of IT support in the workplace, offering training and supervision, and enhancing access to smartphones.

The Effect of Regular Oral Care Protocol on Preventing or Decreasing Severity of Oral Mucositis in Acute Leukemia Patient: A Prospective Trail.

This article reports a study designed to evaluate the effectiveness of regular oral care protocol developed specifically for adults in intensive care to prevent mucositis. Data were collected using oral mucositis assessment scale, oral cavity assessment tool, and the National Cancer Institute Common Toxicity Criteria. The results indicated that oral mucositis can be reduced through the practice of administering oral care in accordance with oral health care guidelines. Oral care implemented in line with an evidence-based oral care guide and frequent observation of patients is the most important step in preventing oral mucositis.

Extending the Reporting Items of Practice Guidelines in Healthcare (RIGHT) statement for reporting Chinese patent medicine guidelines: a protocol

Background: Based on the main document of the Reporting Items of Practice Guidelines in Healthcare (RIGHT) statement, this study will aim to develop the reporting checklist applicable to the guidelines of Chinese patent medicine (CPM). Methods: According to the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network, three well-defined working groups were established, namely the coordination team, the advisory group, and the Delphi panel. The coordination team conducted a literature analysis of the already published CPM guidelines, the extensions of the RIGHT statement, and CPM related reporting specifications to initially form an initial item pool. The Delphi panel of multidisciplinary backgrounds will conduct two rounds of Delphi questionnaires to identify an extension item for RIGHT for CPM. These questionnaires will be sent to each Delphi panel member via email, and each member will independently fill out and provide comments within 10 working days of receiving the questionnaire. Finally, feedback will be provided to the coordination team and the post efficacy assessment of the already published clinical practice guidelines for CPM to determine the final items for RIGHT for CPM checklist. Dissemination: The extended version of the RIGHT for CPM checklist will be published in a peer reviewed journal. Conclusion: We hope that the upcoming RIGHT for CPM checklist provides detailed guidance for developers and users of CPM guidelines, further improving the quality of reports, and promoting the effective dissemination and implementation of CPM guidelines.

Screening for hypertension in adults: protocol for evidence reviews to inform a Canadian Task Force on Preventive Health Care guideline update

PurposeTo inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening in a primary care setting for hypertension in adults aged 18 years and older. This protocol outlines the scope and methods for a series of systematic reviews and one overview of reviews.MethodsTo evaluate the benefits and harms of screening for hypertension, the Task Force will rely on the relevant key questions from the 2021 United States Preventive Services Task Force systematic review. In addition, a series of reviews will be conducted to identify, appraise, and synthesize the evidence on (1) the association of blood pressure measurement methods and future cardiovascular (CVD)-related outcomes, (2) thresholds for discussions of treatment initiation, and (3) patient acceptability of hypertension screening methods. For the review of blood pressure measurement methods and future CVD-related outcomes, we will perform a de novo review and search MEDLINE, Embase, CENTRAL, and APA PsycInfo for randomized controlled trials, prospective or retrospective cohort studies, nested case–control studies, and within-arm analyses of intervention studies. For the thresholds for discussions of treatment initiation review, we will perform an overview of reviews and update results from a relevant 2019 UK NICE review. We will search MEDLINE, Embase, APA PsycInfo, and Epistemonikos for systematic reviews. For the acceptability review, we will perform a de novo systematic review and search MEDLINE, Embase, and APA PsycInfo for randomized controlled trials, controlled clinical trials, and observational studies with comparison groups. Websites of relevant organizations, gray literature sources, and the reference lists of included studies and reviews will be hand-searched. Title and abstract screening will be completed by two independent reviewers. Full-text screening, data extraction, risk-of-bias assessment, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers. Results from included studies will be synthesized narratively and pooled via meta-analysis when appropriate. The GRADE approach will be used to assess the certainty of evidence for outcomes.DiscussionThe results of the evidence reviews will be used to inform Canadian recommendations on screening for hypertension in adults aged 18 years and older.Systematic review registrationThis protocol is registered on PROSPERO and is available on the Open Science Framework (osf.io/8w4tz).

Therapeutic drug monitoring guidelines in oncology: what do we know and how to move forward? Insights from a systematic review.

Compared with anti-infective drugs, immunosuppressants and other fields, the application of therapeutic drug monitoring (TDM) in oncology is somewhat limited. We aimed to provide a comprehensive understanding of TDM guidelines for antineoplastic drugs and to promote the development of individualized drug therapy in oncology. This study type is a systematic review. This study was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Databases including PubMed, Embase, the official websites of TDM-related associations and Chinese databases were comprehensively searched up to March 2023. Two investigators independently screened the literature and extracted data. The methodological and reporting quality was evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and the Reporting Items for Practice Guidelines in Healthcare (RIGHT), respectively. Recommendations and quality evaluation results were presented by visual plots. This study was registered in PROSPERO (No. CRD42022325661). A total of eight studies were included, with publication years ranging from 2014 to 2022. From the perspective of guideline development, two guidelines were developed using evidence-based methods. Among the included guidelines, four guidelines were for cytotoxic antineoplastic drugs, three for small molecule kinase inhibitors, and one for antineoplastic biosimilars. Currently available guidelines and clinical practice provided recommendations of individualized medication in oncology based on TDM, as well as influencing factors. With regard to methodological quality based on AGREE II, the average overall quality score was 55.21%. As for the reporting quality by RIGHT evaluation, the average reporting rate was 53.57%. From the perspective of current guidelines, TDM in oncology is now being expanded from cytotoxic antineoplastic drugs to newer targeted treatments. Whereas, the types of antineoplastic drugs involved are still small, and there is still room for quality improvement. Furthermore, the reflected gaps warrant future studies into the exposure-response relationships and population pharmacokinetics models.

Mapping the Common Barriers to Optimal COPD Care in High and Middle-Income Countries: Qualitative Perspectives from Clinicians.

Chronic obstructive pulmonary disease (COPD) poses a significant global health burden despite being largely preventable and treatable. Despite the availability of guidelines, COPD care remains suboptimal in many settings, including high-income countries (HICs) and upper-middle-income countries (UMICs), with varied approaches to diagnosis and management. This study aimed to identify common and unique barriers to COPD care across six countries (Australia, Spain, Taiwan, Argentina, Mexico, and Russia) to inform global policy initiatives for improved care. COPD care pathways were mapped for each country and supplemented with epidemiological, health-economic, and clinical data from a targeted literature review. Semi-structured interviews with 17 respiratory care clinicians were used to further validate the pathways and identify key barriers. Thematic content analysis was used to generate the themes. Six themes were common in most HICs and UMICs: "Challenges in COPD diagnosis", "Strengthening the role of primary care", "Fragmented healthcare systems and coordination challenges", "Inadequate management of COPD exacerbations", "Limited access to specialized care" and, "Impact of underfinanced and overloaded healthcare systems". One theme, "Insurance coverage and reimbursement challenges", was more relevant for UMICs. HICs and UMICs differ in patient and healthcare provider awareness, primary care involvement, spirometry access, and availability of specialized care. Both face issues with healthcare fragmentation, guideline adherence, and COPD exacerbation management. In addition, UMICs also grapple with resource limitations and healthcare infrastructure challenges. Many challenges to COPD care are the same in both HICs and UMICs, underscoring the pervasive nature of these issues. While country-specific issues require customized solutions, there are untapped possibilities for implementing global respiratory strategies that support countries to manage COPD effectively. In addition to healthcare system-level initiatives, there is a crucial need for political prioritization of COPD to allocate the essential resources it requires.

Parental concerns and vaccine hesitancy against COVID-19 vaccination for children in Greece: A cross-sectional survey

IntroductionParental hesitancy against children’s COVID-19 vaccination remains a challenge globally. Although many studies have explored parental hesitancy, less is known about parental intentions towards COVID-19 vaccination of 6-month to 4-year-old children who were the last age group that became eligible for vaccination and for older children throughout the Omicron predominance period. MethodsWe conducted a nationwide cross-sectional survey from November to December 2022 in Greece. We aimed to explore parental COVID-19 vaccination intentions for their children, reasons against vaccination, and to estimate the association between parents’ intentions and child and parental characteristics and parental attitudes towards COVID-19 vaccination. ResultsOf 431 parents, 243 (56.4 %) had not or did not intend to vaccinate their children against COVID-19. Most parents were vaccinated against COVID-19 (64.7 % no booster; 14.2 % at least one booster). Among parents with children under the age of 5, 13.0 % intended to vaccinate their children against COVID-19, while 47.3 % of parents with children 5 years of age or older reported intention or had already completed vaccination. The most common reasons against COVID-19 vaccination were fear of side effects (32.9 %), perceived short length of clinical trials (29.2 %), and the child having previously contracted COVID-19 (12.0 %). The strongest factors associated with intention or already completed vaccination were parental own vaccination against COVID-19, using a pediatrician or a healthcare professional as the main source of vaccine-related information for their children, agreeing with their pediatrician regarding COVID-19 vaccination, and trusting official healthcare guidelines. Stratified analyses by the two children’s age groups (<5 and 5 to 17) yielded similar estimates. Among parents who had not or did not intend to vaccinate their children, 11.9 % would do so if recommended by a pediatrician. ConclusionsOur findings highlight the need to incentivize healthcare professionals and pediatricians to inform parents about vaccines, clarify misconceptions and address concerns.

Society for Simulation in Healthcare Guidelines for Simulation Training.

Simulation has become a staple in the training of healthcare professionals with accumulating evidence on its effectiveness. However, guidelines for optimal methods of simulation training do not currently exist. Systematic reviews of the literature on 16 identified key questions were conducted and expert panel consensus recommendations determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. These evidence-based guidelines from the Society for Simulation in Healthcare intend to support healthcare professionals in decisions on the most effective methods for simulation training in healthcare. Twenty recommendations on 16 questions were determined using GRADE. Four expert recommendations were also provided. The first evidence-based guidelines for simulation training are provided to guide instructors and learners on the most effective use of simulation in healthcare.

AI guidelines in healthcare for compliance automation

AI guidelines in healthcare for compliance automation

Evidence mapping of clinical practice guidelines on nutritional management for pressure injuries and their quality.

The safety and efficacy of nutritional management for pressure injuries (PIs) have been the subjects of ongoing interest. Some evidence demonstrated that nutrition is essential for skin and tissue viability, supporting tissue repair for healing the pressure injury. This investigation aimed to systematically review clinical practice guidelines (CPGs) for the nutritional management of PIs and furnish an evidence map to assess research trends and CPG gaps. The PubMed, Embase, and guidelines databases, and society websites were searched for CPGs for the nutritional management of PIs. The basic recommendations for the nutritional management of PIs, method quality, and reporting CPGs quality were identified and imported into Excel. Four researchers independently elucidated each CPG's quality via the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist. All bubble charts were generated using Excel software. This review included 12 CPGs with a combined 23 recommendations. The nutrition screening and assessment were summarized on the basis of the PI recommendations for 6 major items, 12 items on nutrition management, and 3 on PI education. The assessed CPGs had mixed quality, and the highest score ± standard deviation based on the clarity of presentation was 83.46 ± 7.62, whereas the lowest mean score based on AGREE II applicability was 53.31 ± 16.90. Field 1 (basic information) in the RIGHT checklist had the greatest reporting rate (68.06%), whereas field 5 (review and quality assurance) had the lowest CPGs quality (41.67%). This investigation furnishes an evidence map and provides new perspectives on the CPGs for the nutritional management of PIs. However, the CPGs included still need improvement, especially in the applicability and editorial independence domains.

Global View of Clinical Guidelines on Prevention of Surgical Site Infections for Health Care Professionals: A Scoping Review

BackgroundEven though there may be clinical guidelines for surgical site infections prevention, no review has been conducted on them. Therefore, a scoping review was undertaken to map and synthesize the available surgical site infections prevention guidelines. MethodologyA scoping review methodology as defined by the Joanna Briggs institute was conducted. Eligible English and French published articles with guidelines were identified from data bases, search engines, and websites of professional organizations. The Search terms included: "health care professionals AND guidelines for surgical site infections prevention OR clinical practice guidelines". First level selection was based on title and abstract while full text for second level. ResultsOut of the 106 articles with guidelines, 7 were selected for the period 1999 to 2021. Four showed methods used to formulate guidelines. Five guidelines comprised recommendations for surgical site infections prevention for pre, intra and post-operative phases. WHO guideline appeared to be robust as it contained all the characteristics. ConclusionOf all the guidelines identified, the WHO guideline indicated population used to develop guidelines; method used and set recommendations, validation including all phases of surgical management. Hence, a recommendation to adapt WHO guideline to health care settings of low resources countries like Rwanda. Rwanda J Med Health Sci 2023;6(3):398-410

A Reporting Tool for Practice Guidelines in Health Care: The RIGHT Statement.

A Reporting Tool for Practice Guidelines in Health Care: The RIGHT Statement.

Vocal tasks for acoustic and/or auditory perceptual analysis for discriminating individuals with and without voice disorders: a systematic review protocol

ObjectiveThe primary objective of the present systematic review is to: (1) identify the current vocal tasks being used for acoustic and/or auditory perceptual analysis to differentiate between individuals with and...

Perspectives of older adults and general practitioners on ageing and cognitive decline in primary care within the context of a decentralised antihypertensive dementia prevention trial

AbstractBackgroundBlood pressure (BP) lowering is the most promising strategy for dementia risk reduction.1 However, few clinical trials have been designed to evaluate the impact of BP lowering on dementia as a primary endpoint, and concerns persist over harms associated with this treatment, particularly in older, frailer people.2 Community engagement will guide the design and conduct of such a trial. To gain a better understanding of concerns and potential barriers in this topic, we undertook focus group discussions with memory‐clinic patients without dementia and interviews with general practitioners to gain insights on the topics of cognitive decline, antihypertensive medications, and motivation to participate in a dementia prevention trial.MethodTwo focus groups (N = 7) with memory‐clinic participants (patients [age ≥60yr] with a history of mild cognitive and/or memory complaints without dementia and family carers of a patient with dementia) and 5 individual interviews with practitioners (metropolitan Sydney) were conducted in July 2022. Thematic analysis was used to identify recurring themes .ResultThe most common themes identified by patients included: valuing clear and timely communication from practitioners; valuing accessible options and considerations for computer‐based testing and treatment; and having fears and experience of dismissal from practitioners and peers about their ageing and declining health. Practitioners identified similar priorities of: clear and timely communication and accessibility in the context of a clinical trial; and insights into how cognitive decline is noticed and how individuals are supported, across different community contexts (i.e., social groups with higher levels of social connection and neighbourly bonds corresponded with lower perceived impact of cognitive decline). Importantly, although practitioners expressed concern for their patients, they reported that time restrictions limited the comprehensiveness of their ability to provide diagnostics and care.ConclusionAlthough limited by sample size, this study identified large issues for the conduct of clinical trials and in community dementia care. These concerns need due consideration for future trial designs and primary healthcare guidelines in the areas of dementia prevention, diagnoses, and care.

Guidelines, Consensus Statements, and Standards for the Use of Artificial Intelligence in Medicine: Systematic Review.

The application of artificial intelligence (AI) in the delivery of health care is a promising area, and guidelines, consensus statements, and standards on AI regarding various topics have been developed. We performed this study to assess the quality of guidelines, consensus statements, and standards in the field of AI for medicine and to provide a foundation for recommendations about the future development of AI guidelines. We searched 7 electronic databases from database establishment to April 6, 2022, and screened articles involving AI guidelines, consensus statements, and standards for eligibility. The AGREE II (Appraisal of Guidelines for Research & Evaluation II) and RIGHT (Reporting Items for Practice Guidelines in Healthcare) tools were used to assess the methodological and reporting quality of the included articles. This systematic review included 19 guideline articles, 14 consensus statement articles, and 3 standard articles published between 2019 and 2022. Their content involved disease screening, diagnosis, and treatment; AI intervention trial reporting; AI imaging development and collaboration; AI data application; and AI ethics governance and applications. Our quality assessment revealed that the average overall AGREE II score was 4.0 (range 2.2-5.5; 7-point Likert scale) and the mean overall reporting rate of the RIGHT tool was 49.4% (range 25.7%-77.1%). The results indicated important differences in the quality of different AI guidelines, consensus statements, and standards. We made recommendations for improving their methodological and reporting quality. PROSPERO International Prospective Register of Systematic Reviews (CRD42022321360); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=321360.

Behavioral guidance for improving dental care in autistic spectrum disorders.

Autism spectrum disorders (ASDs) impair many aspects of everyday life and may prevent access to dental care, often limiting it to emergencies. Impaired oral health has long-lasting negative consequences on health status and on the acquisition of oral habits (e.g., oral respiration and grinding) or competencies (e.g., proper speech production). Children with ASD may be scared in the dental setting, which is rich in sensory stimuli and requires physical contact. Due to their behavioral manifestations, they represent a challenge for dentists and hygienists. We created a dedicated pathway with behavioral support for children with ASD to allow dental care and possibly limit the use of general anesthesia. We evaluated the effects of behavioral support in a quasi-experimental design by comparing two groups of children with ASD. The first group (n = 84) was visited every 2 months for 3 years and received additional support (visual aids, caregiver training, and longer visit duration). A control group, matched for age and sex, was visited at least twice a year or more, if needed, according to standard healthcare guidelines. Compliance with the schedule was high throughout the 3 years. The degree of collaboration significantly improved after 1 year in the supported group, while the control group did not change. At the end of the study, collaboration remained significantly higher than at the beginning in the supported group. Half of dental treatments were possible without general anesthesia in supported children. No adverse effect was apparent on collaboration due to COVID-19 restrictions. Behavioral techniques improved the compliance of ASD children to regular dentistry visits and treatment. Furthermore, oral hygiene at home was similarly improved, addressing oral health from a lifelong perspective.