PREPARED Study
Research type
Research Study
Full title
PREPARED – Prevention options and oral health in patients at risk of developing rheumatoid arthritis
IRAS ID
287819
Contact name
Stefan Serban
Contact email
Sponsor organisation
University of Leeds
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Research Summary
Patients with chronic inflammatory joint disease (rheumatoid arthritis - RA) are more likely to have severe gum disease. Preliminary work for my doctoral research in Birmingham has shown some promising results: gum disease treatment may reduce inflammation and provide overall health benefits. Most of the research so far has been focusing on patients with established joint disease. By this stage it might be too late to reverse the effects of inflammation and joint damage produced by arthritis. The PREPARED study is going to look at patients at risk of developing RA and discuss about their perceptions about oral health. Successful gum disease treatment depends on patients compliance and behaviour change. If gum disease treatment may reduce or even reverse RA progression this opens the door for exciting possibilities for prevention. This project will also interview healthcare professionals (GPs, NHS commissioners, etc) to understand what could be done to make access to oral health easier for these patients. E.g. patients with diabetes often get referred to a foot clinic but they don't get referred to see a dentist. We would like to understand the reasons for this in light of the potential benefits that improved dental health can have on the joints and other conditions associated with inflammation.
All of the patient participants have already been recruited on the “CCP Study” (Co-ordinated Programme to Prevent Arthritis: Can We Identify Arthritis at a Pre-Clinical stage?) at Chapel Allerton Hospital, Leeds.Lay summary of study results
Semistructured interviews were conducted individuals at-risk of developing rheumatoid arthritis (RA) and a range of healthcare professionals. At-risk participant data were analysed using reflexive thematic analysis; subsequent coding of healthcare professional data was deductive, based on a preidentified set of constructs.
Nineteen at-risk individuals and 11 healthcare professionals participated. Three themes (six subthemes) were identified: (1) understanding risk (knowledge of shared at-risk factors; information and communication); (2) oral health perceptions and experiences (personal challenges and opportunities for dental intervention and oral health maintenance; external barriers) and (3) oral health treatment and maintenance (making oral health changes with the aim of preventing RA; acceptability of participation in periodontal research).
Gum disease is common in individuals at risk of RA, but the impact of poor oral health may not be well understood. Oral health information should be tailored to the individual. At-risk participants and healthcare professionals identified seeking dental treatment can be hindered by dental phobia, treatment costs or inability to access dentists. While at-risk individuals may be reluctant to take preventive medications, a clinical trial involving preventive periodontal treatment is potentially acceptable.REC name
East of England - Cambridge East Research Ethics Committee
REC reference
20/EE/0230
Date of REC Opinion
9 Oct 2020
REC opinion
Further Information Favourable Opinion