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BMJ Open. 2017 Sep 25;7(9):e016078. doi: 10.1136/bmjopen-2017-016078.

Barriers and facilitators in the integration of oral health into primary care: a scoping review.

Author information

1
School of Public Health, Université de Montréal, Montréal, Québec, Canada.
2
School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada.
3
Faculty of Dental Medicine, Université de Montréal, Montréal, Québec, Canada.
4
Public Health Research Institute, Université de Montréal, Montréal, Québec, Canada.
5
Faculty of Dentistry, McGill University, Montréal, Québec, Canada.

Abstract

OBJECTIVE:

This scoping study has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care.

METHODS:

Grounded in the Rainbow conceptual model and using the Levac et al six-stage framework, we performed a systematic search of electronic databases, organisational websites and grey literature from 1978 to April 2016. All publications with a focus on the integration of oral health into primary care were included except commentaries and editorials. Thematic analyses were performed to synthesise the results.

RESULTS:

From a total of 1619 citations, 58 publications were included in the review. Barrier-related themes included: lack of political leadership and healthcare policies; implementation challenges; discipline-oriented education; lack of continuity of care and services and patients' oral healthcare needs. The facilitators of integration were supportive policies and resources allocation, interdisciplinary education, collaborative practices between dental and other healthcare professionals, presence of local strategic leaders and geographical proximity.

DISCUSSION AND PUBLIC HEALTH IMPLICATIONS:

This work has advanced the knowledge on the barriers and facilitators at each integration domain and level, which may be helpful if the healthcare organisations decide to integrate oral health and dental services into primary care. The scoping review findings could be useful for both dental and medical workforce and allied primary healthcare providers. They could also guide the development of healthcare policies that support collaborative practices and patient-centred care in the field of primary care.

KEYWORDS:

health research services; integration; oral health; oral medicine; primary care; public health; scoping review

PMID:
28951405
PMCID:
PMC5623507
DOI:
10.1136/bmjopen-2017-016078
[Indexed for MEDLINE]
Free PMC Article

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