MI Assessment of BP and Diabetes Screening Practices Among Oral Health Professionals

This survey is conducted by the Michigan Department of Health & Human Services (MDHHS). You were chosen for this assessment because you are a Dental Professional in Michigan. If you chose to participate in this assessment you will be asked about practices in your dental office regarding hypertension and diabetes screening and knowledge. The purpose of this assessment is to:

·         Assess screening procedures for hypertension and diabetes by oral health professionals.

·         Assess the knowledge of oral health professionals to facilitate referrals for diagnosis and care for hypertension and diabetes.

·         Quantify the referrals for high blood pressure readings and elevated blood glucose levels by oral health professionals.

·         Determine if oral health professionals perform any follow up after making referrals for patients with high blood pressure readings and elevated blood glucose levels.

In addition, results may assist in the development of interventions, pilots, and sharing of best practices. Ultimately the goal is to increase the number of Michigan residents screened and referred to primary care providers by oral health professionals because of elevated blood pressure and/or blood glucose findings.

Taking this assessment is voluntary. Choosing not to fill out all the questions will not harm you in any way. You may skip questions you do not want to answer. All information from this survey will be kept confidential and your identifiable information is not connected to this assessment or your responses in any way.

If you have any questions on how to complete the assessment or would like more information please contact:

Nana Ama Aya Erzuah, MPH

MDHHS
517-373-9803
ErzuahN1@michigan.gov

Susan Deming, RDH, RDA, B.S.

MDHHS

517 373-3624

demings@michigan.gov

Question Title

* 1. Please select your role in your practice. If you are not one of the professionals listed below please forward this survey to someone in your practice who fits one of these descriptions.

Dentist

Dental Hygienist

Dental Assistant

Question Title

* 2. In what type of setting do you practice? (Check the one setting in which you spend the most time )

General Dental Practice

Specialty Practice

Oral Surgery

Hospital Based Clinic

Corporate Dentistry

Academic Institution

Local Health Department

FQHC

Other

Comments:

Question Title

* 3. In what zip code do you practice the most time it?

Question Title

* 4. How many years have you been practicing?

0-5 years

6-10 years

11-15 years

16-20 years

21 years or longer

Question Title

* 5. Which patients do you take blood pressure readings? (Check all that apply)

All adults (18 years and older)

New patients only

Patients with a history of hypertension

Patients who request it

None- Please answer question 7

Other (please specify):

Question Title

* 6. Please rate your comfort level with taking blood pressure

Very Comfortable

Comfortable

Neutral

Uncomfortable

Very uncomfortable

Very Comfortable

Comfortable

Neutral

Uncomfortable

Very uncomfortable

Question Title

* 7. If you selected ‘none’ to question 5 please answer the question below. (Check all that apply)

Too little time in appointment

I do not see the need

Uncomfortable with skill to do this task

Equipment not available

Unable to refer for care

No reimbursement or incentive to perform this procedure

Other (please specify):

Question Title

* 8. Of the choices listed which value would you consider a normal blood pressure reading?

<120/80 mmHg systolic and <80 mmHg diastolic

120-139 mmHg systolic or 80-89 mmHg diastolic

140-159 mmHg systolic or 90-99 mmHg diastolic

>160 mmHg systolic or >100 mmHg diastolic

Other (please specify)

Question Title

* 9. On which patients do you screen for diabetes?

All adults (18 years and older)

New patients only

Patients with a history of diabetes

Patients who request it

None- Please answer question 13

Other (please specify)

Question Title

* 10. Please rate your comfort level with screening for diabetes.

Very Comfortable

Comfortable

Neutral

Uncomfortable

Very uncomfortable

Very Comfortable

Comfortable

Neutral

Uncomfortable

Very uncomfortable

Question Title

* 11. Which of the following methods do you use to screen for diabetes? (Check all that apply)

Periodontal screen (i.e., oral exam for signs)

Questions on health assessment questionnaire

Perform a point-of-care finger stick for random plasma glucose level

Perform a point-of-care finger stick for an A1c hemoglobin test

I do not screen for diabetes- Please answer question 13

Other (please specify)

Question Title

* 12. Of the choices below, what oral signs of elevated blood glucose levels do you primarily use when screening for diabetes? (Check all that apply)

Gingivitis/bleeding gums

Fungal infections

Xerostomia/dry mouth

I do not know

Other (please specify)

Question Title

* 13. If you selected ‘I do not screen for diabetes’ for question 11 please answer why. (Check all that apply)

I consider it outside my scope of practice

I treat the dental condition and suggest they contact their primary care provider

I do not have additional equipment needed for follow-up

The oral signs can indicate too many other medical conditions

Unable to refer for care

No reimbursement or incentive for procedure

Other (please specify)

Question Title

* 14. Check all the options below that you normally would do when a screening reveals a patient with hypertension, high hemoglobin A1c, or risk for prediabetes, in your practice?

Diabetes: A1c: =/>6.5%, Fasting Plasma Glucose: =/> 126 mg/dl. /2 hour OGTT: =/> 200 mg/dl, Random Plasma Glucose: =/> 200 mg/dl with classic symptoms in the absence of unequivocal hyperglycemia, should be confirmed with repeat testing.
Prediabetes: A1c: 5.7-6.4%, Fasting Plasma Glucose: 100-125 mg/dl, 2 hour OGTT: 140-199 mg/dl

	Provide patient education	I contact the patient's primary care provider	My office contacts the patient's primary care provider	I inform the patient to follow up with their primary care provider	Nothing
Hypertension	Hypertension Provide patient education	Hypertension I contact the patient's primary care provider	Hypertension My office contacts the patient's primary care provider	Hypertension I inform the patient to follow up with their primary care provider	Hypertension Nothing
High Hemoglobin A1c	High Hemoglobin A1c Provide patient education	High Hemoglobin A1c I contact the patient's primary care provider	High Hemoglobin A1c My office contacts the patient's primary care provider	High Hemoglobin A1c I inform the patient to follow up with their primary care provider	High Hemoglobin A1c Nothing
Prediabetes	Prediabetes Provide patient education	Prediabetes I contact the patient's primary care provider	Prediabetes My office contacts the patient's primary care provider	Prediabetes I inform the patient to follow up with their primary care provider	Prediabetes Nothing

Question Title

* 15. If you make a referral for a patient with high blood pressure, or elevated risk of diabetes do you also perform a follow up after making the referral?

Yes

Sometimes

Other (please specify)

Question Title

* 16. If yes, with whom do you follow up?

Patient

Provider

Both

Other (please specify)

Question Title

* 17. What are your suggestions for receiving educational resources on hypertension and diabetes to oral health professionals? (Check all that apply)

Online CE course

Webinars

Informational pamphlets and fact sheets

Reference card on hypertension/diabetes guidelines

Onsite refresher trainings

None needed

Other (please specify)

Thank you for participating in this survey!

We value your input on this important topic.