Materials and Methods: A self-administered questionnaire on KAP in the management of DM patients with PD was posted to 725 medical officers (MOs) and family medicine specialists (FMSs) in MOH clinics in Kedah, Terengganu, Johor and Negeri Sembilan. Collected data were tabulated and analysed using descriptive and regression analyses (simple and multiple). Statistical significance was defined as p < 0.05.
Results: A total of 549 MPs responded. The majority of MPs were MOs (92.6%) and female (75.8%). FMSs had a greater awareness of PD when compared to MOs (p = 0.002). All MPs had good knowledge, except for the incorrect notion that excessive sugar causes PD (94.3%). Overall, FMSs had better knowledge when compared to MOs (p=0.026). The majority of MPs agreed that 'they should update their knowledge on the association between systemic disease and PD' (89.6%) and claimed that 'it was not their responsibility to examine DM patients for PD' (83.1%). Most MPs did not enquire or examine for PD in their DM patients. More FMSs (67.5%) referred patients to dentists compared to MOs (31.6%).
Conclusion: Most MPs have sufficient knowledge on PD, but a negative attitude in the management of PD in DM patients. The reasons for not referring included workload and patients refusing referral.
METHODS: Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N = 165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€ = MYR4).
RESULTS: A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P = 0.003). Higher costs were expended as disease severity increased (ANOVA, P = 0.022) and for patients requiring surgeries (ANOVA, P