title: MRONJ risk reduction pathway - 360 degree survey.
abstract: Introduction Bisphosphonates and denosumab reduce the risk of skeletal events in some malignancies (for example, breast, myeloma). These drugs carry a significant risk of a difficult-to-manage side effect of medication related osteonecrosis of the jaw (MRONJ). Preventive dental screening and treatment reduces the incidence of MRONJ. A managed clinical network (MCN) has been used to provide a MRONJ risk reduction pathway. A 360 degree survey was undertaken to assess the effectiveness of the pathway.Aim The aim of the 360 degree survey was to evaluate if this preventive pathway fulfilled its aims based on patient and stakeholder responses.Method A multidisciplinary, cross-service, cross-health board MRONJ preventive pathway has been developed. A 360 degree feedback survey of patients and other stakeholders was undertaken.Results Overall, this survey revealed high levels of satisfaction across patients, oncologists, community dental services, general dental services, and hospital managers.Conclusion Alternative ways of delivering MRONJ preventive pathways can be developed and assessed using iterative stakeholder feedback aided by a robust clinical governance framework.
authors.affiliation: Associate Specialist, Dept of Restorative Dentistry, Morriston Hospital, ABM University Health Board, Swansea, SA6 6NL.
authors.forename: A
authors.initials: A
authors.lastname: Muthukrishnan
authors.affiliation: Consultant and MDT Lead Clinician, Dept of Haematology and Haemato-oncology, Singleton hospital, ABM University Health Board, Swansea, SA2 8QA.
authors.forename: S
authors.initials: S
authors.lastname: Al-Ismail
authors.affiliation: Dept of Oncology, Singleton hospital, ABM University Health Board, Swansea, SA2 8QA.
authors.forename: G
authors.initials: G
authors.lastname: Bertelli
authors.affiliation: Restorative Dentistry Oncology Co-ordinator, Morriston Hospital, ABM University Health Board, Swansea, SA6 6NL.
authors.forename: P
authors.initials: P
authors.lastname: Browne
mesh_terms: D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000453:epidemiology / Q000517:prevention & control*; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D040242:Risk Reduction Behavior