Projects
042 - Evaluating the effect of MIMS Drugs4Dent on Safety of Prescribing and Peri-operative Medication Management among Dentists
- Chief Investigator A: Dr Nadia Kaunein
- Chief Investigator B: A/Prof Leanne Teoh
- Chief Investigator C: Prof. Michael McCullough
- Chief Investigator D: Dr Mathew Lim
Introduction
Medication safety is a critical concern in dental practice. Dentists frequently prescribe antibiotics, analgesics, and anxiolytics; however, inappropriate prescribing remains common. A national survey of Australian general dentists reported that 55% of respondents occasionally or routinely overprescribed antibiotics, and 46% prescribed anxiolytics outside guideline-recommended regimens (Teoh et al., 2019). Such deviations from evidence-based practice contribute to antimicrobial resistance, therapeutic failure, and increased risk of adverse events (Australian Prescriber, 2021).
The Prescribing Competencies Framework (second edition) outlines the essential capabilities required for safe, effective, and person-centred prescribing. These include gathering and interpreting clinical information, making evidence-based decisions, communicating with patients and other health professionals, and monitoring treatment outcomes (NPS MedicineWise, 2021). These competencies are highly relevant to dental practice, where clinicians must consider drug–drug, drug–disease and drug–allergy interactions, yet often lack clinical decision-support tools tailored to dentistry.
Peri-operative medication management further increases complexity. Medications such as anticoagulants, antiresorptive agents, immunosuppressants and thyroid therapies can significantly influence dental procedures. Dentists must evaluate risks, make informed decisions on continuing or modifying therapy, and when appropriate, collaborate with medical colleagues. Despite this complexity, dentistry-specific, real-time prescribing support remains limited. MIMS Drugs4Dent is a novel medicine decision-support tool designed specifically for Australian dentists. It integrates drug-interaction checking with peri-operative prescribing guidance contextualised to dental procedures (MIMS, 2021). Evaluating this tool through a randomised controlled trial has the potential to enhance prescribing safety, support antimicrobial stewardship, and improve the quality of peri-operative medication decisions in everyday dental practice.
Aims
To evaluate the effectiveness of MIMS Drugs for Dent in improving the safety of prescribing and peri-operative medication management in dental practice versus current practices.
Objectives:
1.To assess the effect of MIMS Drugs4dent on improving the safety of prescribing and detecting dental peri-operative medicine interactions, as measured by a standardised test (compared to what general current practise is).
2.To evaluate the effect of MIMS Drugs4dent on avoiding potential drug-drug and drug-disease interactions (compared to what general current practise is).
3.To evaluate the effect of MIMS Drugs4dent on detecting dental peri-operative medicine interactions, or the impact of drugs on dental treatment where either the drug may need to be temporarily suspended, or the procedure delayed
4.To evaluate the effect of MIMS Drugs4dent on promoting correct prescribing practices, including appropriate regimen of chosen
prescribed drugs, including dose duration, and frequency (compared to what general current practise is).
Methodology
Study Design:
This study will employ a prospective, parallel group, randomised controlled trial design with two groups: an intervention group and a control group.
Participants: The study will recruit licensed dentists currently practicing in Australia.
Recruitment Strategy:
• A call out will be sent asking dentists to take part in this RCT through professional organisations/associations such as evident.
• Incentives: 300$ gift voucher for participation, and free access to a medicine decision making tool for 1 month.
Participants will be randomly assigned to either the intervention group or the control group using a computer-generated randomisation sequence with a 1:1 allocation ratio, stratified by practice setting (private or public), location and years of experience. An independent researcher will perform the randomisation to ensure allocation concealment.
Inclusion Criteria:
• Registered dentists practicing in Australia
Exclusion Criteria:
• Dentists who are not currently practicing
• Dentists who are unable to use the MIMS Drugs for Dent software or participate in the study due to physical or cognitive limitations (older dentists not tech savy etc).
• Dentists who already use Drugs 4 Dent. This information will be collected while obtaining consent. A list of multiple clinical tools will be included in the consent forms, and the participants will
Blinding: Due to the nature of the intervention, full blinding is not possible. However, outcome assessors, statisticians, lead researchers will be blinded to group allocation.
Standardised test to be fully anonymous. The participant will be required to enter their participant IDs allocated to them which will be managed by third party - Independent researcher.
Intervention group: The intervention group will receive access to the MIMS Drugs 4 Dent website and training on its use. Researchers will record a short video on how to use/access different areas within the website. Control group: Delayed intervention: We will send them an email that they are in the intervention group and that they need to complete a baseline survey before getting access to the intervention. The baseline survey will be the test or outcome assessment.
Both groups will receive different information forms:
- Intervention group gets the website and then quiz after 2 weeks of D4D use.
- Control group gets a letter stating that they need to complete the questionnaire (i.e test) before they get access to the invention.
Data Collection: Anonymous questionnaire/test with 10 case scenarios. All questions will be scored (1 point per question if answered correctly). All participants will be given participant IDs (by the independent researcher deidentifying the data) and will be completing their test under observation to ensure control group participants can’t access this information online or use AI models to complete the test. Further, the following steps will be undertaken:
- Participants will be under observation and sharing their screen (full desktop view) while completing this test online.
- Those in the intervention group can use MIMS Drugs4Dent when completing the test.
