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DENTAL SCIENCE - ORIGINAL ARTICLE
Year : 2014  |  Volume : 6  |  Issue : 5  |  Page : 171-173  

Patient compliance and supportive periodontal therapy: Study among young adults of Namakkal district


1 Department of Periodontics, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengodu, Namakkal, Tamil Nadu, India
2 Department of Oral Medicine, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengodu, Namakkal, Tamil Nadu, India
3 Department of Oral Surgery, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengodu, Namakkal, Tamil Nadu, India

Date of Submission18-Apr-2014
Date of Decision18-Apr-2014
Date of Acceptance23-Apr-2014
Date of Web Publication25-Jul-2014

Correspondence Address:
Dr. Subramanium Gokulanathan
Department of Periodontics, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengodu, Namakkal, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-7406.137443

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   Abstract 

Aims: The aim of this study is to assess the patient compliance to supportive and maintenance periodontal therapy and to determine the reason for noncompliance among young adult patients of Namakkal district, India. Materials and Methods: This was a cross-sectional study conducted on 400 patients who underwent periodontal therapy and subsequently recalled for supportive and maintenance periodontal treatment in the Department of Periodontics, Vivekanandha Dental College for Women, Namakkal. Patients age group 25-35 years and of both gender were equally selected and grouped by occupation and socioeconomic status. According to their compliance with appointments, they are categorized as complete compliance, partially compliance and insufficient or noncompliance. Noncompliance and partially compliance patients were contacted and asked to rate their experience and reason for noncompliance. Results: In this study, 80% of patients showed complete compliance and were regular for supportive periodontal therapy appointments. Women were more regular in maintaining recall appointments than men. Salaried employers showed 84.3% complete compliance, while self-employed personals showed 77% complete compliance and 75% of nonworking personals were regular to the appointment schedule. Noncompliance person has quoted lack of time and forgetting the appointment date as a major reason for missed appointments. Conclusions: This study recommends the need for improvement in communication skills of practitioners and weekend appointment for patient undergoing periodontal maintenance therapy.

Keywords: Appointment, compliance, maintenance therapy, periodontal therapy


How to cite this article:
Gokulanathan S, Balan N, Aravind RJ, Thangavelu K. Patient compliance and supportive periodontal therapy: Study among young adults of Namakkal district. J Pharm Bioall Sci 2014;6, Suppl S1:171-3

How to cite this URL:
Gokulanathan S, Balan N, Aravind RJ, Thangavelu K. Patient compliance and supportive periodontal therapy: Study among young adults of Namakkal district. J Pharm Bioall Sci [serial online] 2014 [cited 2019 Nov 14];6, Suppl S1:171-3. Available from: http://www.jpbsonline.org/text.asp?2014/6/5/171/137443

The goal of the periodontal treatment is to increase the longevity of the person natural dentition and maintain them in functional health and comfort by preserving the supporting structures of the teeth. Supportive and maintenance periodontal therapy helps to achieve this lofty goal by the long-term recall and treatment. Supporting periodontal therapy is essential for success of any periodontal disease treatment and is often considered as a fundamental component of all periodontal therapy. Compliance [1] to recall visit is directly related to medium and long-term success of active periodontal therapy.

In developing countries, the most common reason for seeking medical and dental treatment is pain and discomfort. Unlike dental caries, periodontal diseases seldom cause acute pain and discomfort, hence patient motivation toward periodontal treatment is a challenging aspect. Periodontal diseases are mostly chronic and their treatment is unique as it requires long-term therapy, maintenance, and frequent follow-ups. These three factors are solely dependent on patient compliance. The compliance in medical treatment is referred as the extent to which the patient follows medical instructions. In any chronic diseases treatment like periodontal therapy the instructions are considered to be an essential component of primary treatment itself. The instructions context here includes home care maintenance, frequent recall follow-up for examination and review, drug therapy as well as maintenance or supportive periodontal treatments. Well-controlled maintenance care [2],[3] is a key consideration in the long-term prognosis of treated periodontitis patients. The aim of this study is to assess the patient compliance to supportive and maintenance periodontal therapy by assessing their recall visit appointments and to determine the reason for irregularity or noncompliance toward periodontal therapy.


   Materials and Methods Top


This study consists of 400 patients who attended the Department of Periodontics, Vivekanandha Dental College for Women during May 2011 to June 2013 for supportive periodontal therapy. The patients between ages of 25 and 35 years, of both genders were randomly selected. The patient compliance was assessed only after completion of etiotropic or primary surgical or restorative treatment phase therapy. The patients were grouped under gender and according to occupation status for establishing the relation between compliance and occupation and gender. The patients were grouped according to their occupation, which reflects their socioeconomic status as follows

  • Group 1 - professionals/self-employed/business
  • Group 2 - daily wagers and monthly salaried persons
  • Group 3 - nonworking class.


According to thier compliance, the patients were categorized into three groups namely, complete compliance, irregular or partial compliance and insufficient or noncompliance. If the patient has attended 50% or above appointments within 2 days range of date of appointments they are grouped as partial compliance. Those who fail to keep <50% appointments are grouped under noncompliance. The patient who is partial compliance and noncompliance were contacted through phone, E-mail, and personal visits. They were requested to rate their experience, motivation and patient education about the disease and treatment options in a three-point satisfaction questionnaire. They were asked to provide the score of value 0, 1, and 2 for the following three questions as follows.

  • Question number 1: How was the experience? Reception, hospitality, and treatment
  • Question number 2: Do you think that the information provided to you about disease, treatment options, and treatment course was sufficient?
  • Question number 3: Did the doctor and reception person motivated you for the treatment and kept a personal care and a good record of follow-up?
  • Score 0 - bad experience/adequate information about the disease and treatment were not given/not motivated
  • Score 1 - average experience/satisfactory with information/adequate motivation
  • Score 2 - happy experience/completely satisfied with treatment explanation/good motivation.


They were also suggested to provide the reason for their irregularity or noncompliance.


   Results Top


Of 400 patients selected, 200 were women and 200 were men. Totally 162 women and 162 men were complete compliance with the supportive periodontal therapy. Twenty-nine women and 31 men were partially compliance [Table 1] and 13 men and 7 women were noncompliance to supportive follow-up treatments. Of the 196 persons who are either self-employed or professional, [Table 2] 151 was complete compliance to the recall appointments; while 32 of them were partially irregular and 13 were noncompliance. Of the 172 persons who are a salaried employee 145 was regular to the recall appointments and 24 of them were partially compliance and 3 were noncompliant. Self-employed personals showed 77% complete compliance, 16.6% partial compliance and 6.6% noncompliance to recall appointments. Salaried employers showed 84.3% complete compliance, 13.9% partial compliance, and 1.7% noncompliance to the recall appointments. Nonworking class personals had 75% complete compliance rate, 12.5% were irregular and 12.5% were noncompliant to the maintenance appointments. A total of 80 patients partial compliance and noncompliance personals were asked to fill the three question satisfaction questionnaire and their scores were tabulated in [Table 3]. Sixteen patients have suggested poor motivation, eight had a bad experience, while 20 of them had felt that the information provided about the disease and treatment was inadequate.
Table 1: Distribution of compliance among gender


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Table 2: Distribution of compliance among occupation


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Table 3: Satisfaction survey score by partial compliance and noncompliance patients


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   Discussion Top


Quality oral health care is an essential component for holistic health of general well-being and it significantly affects the quality of health. Periodontal diseases require long-term maintenance and continuous maintenance care. Compliance to recall visits [1] by the patients is the responsibility of both practitioners and patients. In this study, overall 80% showed complete compliance and were regular for supportive appointments. Women showed 10% more compliance to supportive periodontal treatment than men similar to Demetriou et al. [4] study. However, in Checchi et al. [5] study there was no significant relationships were found between the degree of compliance and patient gender, recall schedule or type of treatment procedure performed. Noncompliance was high among nonworking personals and lowest among salaried personals. This study showed that salaried personals are more satisfied, understanding as well as more interested to periodontal treatment. Further motivation and education can result in complete compliance to therapy. Professionals and self-employed personals in their reason for failure to compliance have complained the time factor as a major reason. They suggested weekend appointments for better compliance. Many have preferred for evening appointments and Sunday recalls. Nonworking class showed very poor compliance to treatment. The major reason suggested by them was a lack of motivation and inadequate understanding of disease and treatment options. This study stress for more patient counseling as well as education sessions for improving compliance to treatment. 35% of people said that lack of any discomfort after active therapy made them to abandon further appointments and recalls. This was similar to findings by Mendoza et al. [6] study where a significant proportion considered that they no longer required treatment. Only four out of 80 have complained of bad experience and poor motivation. Periodontal maintenance therapy [7] is dependent both upon methods of disease control that are either patient or therapist applied as well as on compliance with regular recall schedules. Bad experiences result due to poor understanding of treatment procedure and lack of motivation. Practitioners as well as patient should cooperate to improve the relationship. This can be achieved by increasing patient counseling sessions and use of audio video aids in patient education.


   Conclusion Top


This study is performed in the Department of Periodontics and Department of Community Dentistry, Vivekanandha Dental College for Women. All patients were randomly selected to include patients of all socioeconomic class. The supportive periodontal therapy is offered free hence cost of therapy role in our compliance study is not considered. Despite free treatment offered nonworking class showed poor compliance. Success of any periodontal therapy lies within patient compliance. This study stresses the importance of patient education and motivation. It calls for improvement in communication skills and the use for visual aids in patient education. The study suggested for week end appointment protocol for improving patient compliance. Patient should be reminded about their appointment in advance. Most of the patient's preferred mobile text messaging 1 day prior to the appointment as choice of reminder. If these suggestions are practiced we can achieve drastic improvement in compliance among patient seeking supportive periodontal therapy.

 
   References Top

1.Fenol A, Mathew S. Compliance to recall visits by patients with periodontitis - Is the practitioner responsible? J Indian Soc Periodontol 2010;14:106-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Ramfjord SP. Maintenance care for treated periodontitis patients. J Clin Periodontol 1987;14:433-7.  Back to cited text no. 2
    
3.Alcouffe F, Etienne D. Maintenance therapy. Review of the literature. J Parodontol 1990;9:259-67.  Back to cited text no. 3
    
4.Demetriou N, Tsami-Pandi A, Parashis A. Compliance with supportive periodontal treatment in private periodontal practice. A 14-year retrospective study. J Periodontol 1995;66:145-9.  Back to cited text no. 4
    
5.Checchi L, Pelliccioni GA, Gatto MR, Kelescian L. Patient compliance with maintenance therapy in an Italian periodontal practice. J Clin Periodontol 1994;21:309-12.  Back to cited text no. 5
    
6.Mendoza AR, Newcomb GM, Nixon KC. Compliance with supportive periodontal therapy. J Periodontol 1991;62:731-6.  Back to cited text no. 6
    
7.Hancock EB, Newell DH. The role of periodontal maintenance in dental practice. J Indiana Dent Assoc 2002;81:25-30.  Back to cited text no. 7
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]


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