Patient-reported orofacial-dental pain severity and tele-triage decisions during COVID-19 pandemic: Does the severity of pain drive tele-triage decisions?
BMC Oral Health
; 22(1): 310, 2022 07 27.
Article
in English
| MEDLINE | ID: covidwho-1962806
ABSTRACT
BACKGROUND:
Globally, with the COVID-19 pandemic, dental services were limited to emergency/ urgent conditions and were provided only after tele-triage referral for face-to-face management. However, no previous research explored whether the pain severity (PS) drives the tele-triage decisions. The current study examined the association between PS and tele-triage decision of whether to manage the condition remotely or refer the caller for face-to-face management.METHODS:
This retrospective cross-sectional study analyzed the PS reported by hotline callers, using numerical rating scale (NRS-11), during the first wave of COVID-19 lockdown (23 March-31 August 2020) and its association with tele-triage decision controlling for age, sex, history of chronic illness, and dental discipline needed. Binomial logistic regression assessed the association between the PS (exposure) and tele-triage decision (outcome). ANOVA compared PS across tele-triage categories, dental history and tentative diagnosis.RESULTS:
PS was significantly associated with tele-triage decisions (p < 0.05). An increase in pain score by 1 unit was associated with 1.4 times increased odds of face-face referral (95% CI 1.26-1.54). Pediatric/ adolescent patients (9-18 years) (odds ratio (OR) = 2.07; 95% CI 1.07-4.02), history of chronic illness (OR = 2.12; 95% CI1.28-3.51), need for surgical specialty (OR = 1.93; 95% CI 1.22-3.04) and orthodontic specialty (OR = 7.02; 95% CI 3.54-13.87) were independently associated with tele-triage decision. PS was highest for the emergency triage category (8.00 ± 2.83, P < 0.0001), dental history of tooth with cavity or filling (6.65 ± 2.024, P < 0.0001), and the tentative tele-diagnosis of cellulitis (7.75 ± 2.872, P < 0.0001).CONCLUSIONS:
During COVID-19 pandemic, tele-triage decisions were significantly influenced by patient-reported PS, adjusting for a range of variables. Despite this, referral for face-to-face management was individualized and driven by the tripartite considerations of the reported pain, clinical judgement, and the high transmission characteristics of COVID-19.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Triage
/
COVID-19
Type of study:
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Adolescent
/
Child
/
Humans
Language:
English
Journal:
BMC Oral Health
Journal subject:
Dentistry
Year:
2022
Document Type:
Article
Affiliation country:
S12903-022-02340-w
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