Trial Outcomes & Findings for Clinical Management of Anxiety and Access to Health Care (NCT NCT02081365)

NCT ID: NCT02081365

Last Updated: 2017-01-27

Results Overview

The Modified Dental Anxiety Scale a five-item self-report measure that assesses fear of dental procedures, including drilling, scaling and polishing (i.e., cleaning), and local anesthetic injections. Sample items include, "If you went to your dentist for treatment tomorrow, how would you feel?" and "If you were about to have your tooth drilled, how would you feel?" Items are rated on a five-point Likert-type scale ranging from 1 (not anxious) to 5 (extremely anxious). Scale 0-25. We considered patients who scored \> 19 on the MDAS at baseline or endorsed at least two MDAS items \> 4 to have high dental anxiety.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

151 participants

Primary outcome timeframe

Change from one week before dentist appointment to 1 month after dentist appointment

Results posted on

2017-01-27

Participant Flow

Participant milestones

Participant milestones
Measure
Immediate Treatment
Before the intervention, participants completed self-report questionnaires and a telephone diagnostic interview. Participants in the immediate treatment group were asked to come in 1.5 hours before a previously scheduled dental appointment to complete the computerized cognitive-behavioral therapy dental anxiety intervention (C-CBT). The C-CBT consisted of a single-session, one-hour computerized intervention that assisted the participant in building skills for managing his or her dental anxiety. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Waiting List Control
Before their dental appointments, participants completed self-report questionnaires and a telephone diagnostic interview. Waiting list control participants attended their scheduled dental appointment without receiving the computerized cognitive-behavioral therapy dental anxiety intervention but were offered the opportunity to receive the same intervention following all of their study assessments. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Overall Study
STARTED
74
77
Overall Study
Received Allocated Intervention
46
59
Overall Study
COMPLETED
44
54
Overall Study
NOT COMPLETED
30
23

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Clinical Management of Anxiety and Access to Health Care

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Immediate Treatment
n=74 Participants
Before the intervention, participants completed self-report questionnaires and a telephone diagnostic interview. Participants in the immediate treatment group were asked to come in 1.5 hours before a previously scheduled dental appointment to complete the computerized cognitive-behavioral therapy dental anxiety intervention (C-CBT). The C-CBT consisted of a single-session, one-hour computerized intervention that assisted the participant in building skills for managing his or her dental anxiety. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Waiting List Control
n=77 Participants
Before their dental appointments, participants completed self-report questionnaires and a telephone diagnostic interview. Waiting list control participants attended their scheduled dental appointment without receiving the computerized cognitive-behavioral therapy dental anxiety intervention but were offered the opportunity to receive the same intervention following all of their study assessments. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Total
n=151 Participants
Total of all reporting groups
Age, Continuous
44.7 years
STANDARD_DEVIATION 12.8 • n=99 Participants
44.6 years
STANDARD_DEVIATION 13.6 • n=107 Participants
44.7 years
STANDARD_DEVIATION 13.1 • n=206 Participants
Gender
Female
52 Participants
n=99 Participants
41 Participants
n=107 Participants
93 Participants
n=206 Participants
Gender
Male
22 Participants
n=99 Participants
36 Participants
n=107 Participants
58 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
n=99 Participants
5 Participants
n=107 Participants
10 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
53 Participants
n=99 Participants
58 Participants
n=107 Participants
111 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
16 Participants
n=99 Participants
14 Participants
n=107 Participants
30 Participants
n=206 Participants
Race/Ethnicity, Customized
White
20 participants
n=99 Participants
18 participants
n=107 Participants
38 participants
n=206 Participants
Race/Ethnicity, Customized
Black or African American
34 participants
n=99 Participants
44 participants
n=107 Participants
78 participants
n=206 Participants
Race/Ethnicity, Customized
Asian
2 participants
n=99 Participants
2 participants
n=107 Participants
4 participants
n=206 Participants
Race/Ethnicity, Customized
Other
6 participants
n=99 Participants
3 participants
n=107 Participants
9 participants
n=206 Participants
Race/Ethnicity, Customized
Not reported/missing
12 participants
n=99 Participants
10 participants
n=107 Participants
22 participants
n=206 Participants
MDAS Baseline Score
19.5 units on a scale
STANDARD_DEVIATION 2.9 • n=99 Participants
19.6 units on a scale
STANDARD_DEVIATION 2.6 • n=107 Participants
19.5 units on a scale
STANDARD_DEVIATION 2.8 • n=206 Participants
ADIS Specific Phobia Fear Rating
5.6 units on a scale
STANDARD_DEVIATION 1.3 • n=99 Participants
5.2 units on a scale
STANDARD_DEVIATION 1.4 • n=107 Participants
5.4 units on a scale
STANDARD_DEVIATION 1.3 • n=206 Participants
ADIS Specific Phobia Avoidance Rating
4.6 units on a scale
STANDARD_DEVIATION 2.2 • n=99 Participants
3.9 units on a scale
STANDARD_DEVIATION 2.5 • n=107 Participants
4.2 units on a scale
STANDARD_DEVIATION 2.4 • n=206 Participants
ADIS Specific Phobia Clinical Severity Rating
5.3 units on a scale
STANDARD_DEVIATION 1.4 • n=99 Participants
4.8 units on a scale
STANDARD_DEVIATION 1.6 • n=107 Participants
5.0 units on a scale
STANDARD_DEVIATION 1.5 • n=206 Participants

PRIMARY outcome

Timeframe: Change from one week before dentist appointment to 1 month after dentist appointment

The Modified Dental Anxiety Scale a five-item self-report measure that assesses fear of dental procedures, including drilling, scaling and polishing (i.e., cleaning), and local anesthetic injections. Sample items include, "If you went to your dentist for treatment tomorrow, how would you feel?" and "If you were about to have your tooth drilled, how would you feel?" Items are rated on a five-point Likert-type scale ranging from 1 (not anxious) to 5 (extremely anxious). Scale 0-25. We considered patients who scored \> 19 on the MDAS at baseline or endorsed at least two MDAS items \> 4 to have high dental anxiety.

Outcome measures

Outcome measures
Measure
Immediate Treatment
n=74 Participants
Before the intervention, participants completed self-report questionnaires and a telephone diagnostic interview. Participants in the immediate treatment group were asked to come in 1.5 hours before a previously scheduled dental appointment to complete the computerized cognitive-behavioral therapy dental anxiety intervention (C-CBT). The C-CBT consisted of a single-session, one-hour computerized intervention that assisted the participant in building skills for managing his or her dental anxiety. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Waiting List Control
n=77 Participants
Before their dental appointments, participants completed self-report questionnaires and a telephone diagnostic interview. Waiting list control participants attended their scheduled dental appointment without receiving the computerized cognitive-behavioral therapy dental anxiety intervention but were offered the opportunity to receive the same intervention following all of their study assessments. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Change in Modified Dental Anxiety Scale
Baseline
19.5 units on a scale
Standard Error 0.34
19.6 units on a scale
Standard Error 0.30
Change in Modified Dental Anxiety Scale
One month follow up
15.4 units on a scale
Standard Error 0.74
17.6 units on a scale
Standard Error 0.63

SECONDARY outcome

Timeframe: Change from one week before dental appointment to one-month after dental appointment

The Anxiety Disorders Interview Schedule for DSM-IV is a semi-structured diagnostic interview for assessing DSM-IV criteria for current anxiety, depressive, somatoform, and substance use disorders. For the present investigation, only the specific phobia module of the ADIS-IV was administered to assess the presence and severity of a current diagnosis of dental phobia. Various aspects of dental phobia were assessed using the specific phobia module of the ADIS-IV. Interviewers assessed participants' anxiety and avoidance of dental procedures on scales that ranged from 0 (none) to 8 (very severe). They also rated patients' overall distress and impairment due to their dental phobia symptoms and assigned a clinician's severity rating (CSR) that also ranged from 0 (none) to 8 (very severe); a CSR \> 4 indicated that the participant met criteria for diagnosis of dental phobia.

Outcome measures

Outcome measures
Measure
Immediate Treatment
n=52 Participants
Before the intervention, participants completed self-report questionnaires and a telephone diagnostic interview. Participants in the immediate treatment group were asked to come in 1.5 hours before a previously scheduled dental appointment to complete the computerized cognitive-behavioral therapy dental anxiety intervention (C-CBT). The C-CBT consisted of a single-session, one-hour computerized intervention that assisted the participant in building skills for managing his or her dental anxiety. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Waiting List Control
n=63 Participants
Before their dental appointments, participants completed self-report questionnaires and a telephone diagnostic interview. Waiting list control participants attended their scheduled dental appointment without receiving the computerized cognitive-behavioral therapy dental anxiety intervention but were offered the opportunity to receive the same intervention following all of their study assessments. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Change in Clinical Severity Rating for Specific Phobia Module of Anxiety Disorders Interview Schedule for DSM-IV
Baseline
5.3 units on a scale
Standard Error 0.19
4.8 units on a scale
Standard Error 0.20
Change in Clinical Severity Rating for Specific Phobia Module of Anxiety Disorders Interview Schedule for DSM-IV
One month follow up
3.4 units on a scale
Standard Error 0.27
4.0 units on a scale
Standard Error 0.23

SECONDARY outcome

Timeframe: Change from one week before appointment to one month after appointment

The Anxiety Disorders Interview Schedule for DSM-IV is a semi-structured diagnostic interview for assessing DSM-IV criteria for current anxiety, depressive, somatoform, and substance use disorders. For the present investigation, only the specific phobia module of the ADIS-IV was administered to assess the presence and severity of a current diagnosis of dental phobia. Various aspects of dental phobia were assessed using the specific phobia module of the ADIS-IV. Interviewers assessed participants' anxiety and avoidance of dental procedures on scales that ranged from 0 (none) to 8 (very severe). They also rated patients' overall distress and impairment due to their dental phobia symptoms and assigned a clinician's severity rating (CSR) that also ranged from 0 (none) to 8 (very severe); a CSR \> 4 indicated that the participant met criteria for diagnosis of dental phobia.

Outcome measures

Outcome measures
Measure
Immediate Treatment
n=52 Participants
Before the intervention, participants completed self-report questionnaires and a telephone diagnostic interview. Participants in the immediate treatment group were asked to come in 1.5 hours before a previously scheduled dental appointment to complete the computerized cognitive-behavioral therapy dental anxiety intervention (C-CBT). The C-CBT consisted of a single-session, one-hour computerized intervention that assisted the participant in building skills for managing his or her dental anxiety. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Waiting List Control
n=63 Participants
Before their dental appointments, participants completed self-report questionnaires and a telephone diagnostic interview. Waiting list control participants attended their scheduled dental appointment without receiving the computerized cognitive-behavioral therapy dental anxiety intervention but were offered the opportunity to receive the same intervention following all of their study assessments. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Change in Fear Rating for Specific Phobia Module of Anxiety Disorders Interview Schedule for DSM-IV
Baseline
5.6 units on a scale
Standard Error 0.17
5.2 units on a scale
Standard Error 0.17
Change in Fear Rating for Specific Phobia Module of Anxiety Disorders Interview Schedule for DSM-IV
One month follow up
3.8 units on a scale
Standard Error 0.26
4.8 units on a scale
Standard Error 0.23

SECONDARY outcome

Timeframe: Change from one week before appointment to one month after appointment

The Anxiety Disorders Interview Schedule for DSM-IV is a semi-structured diagnostic interview for assessing DSM-IV criteria for current anxiety, depressive, somatoform, and substance use disorders. For the present investigation, only the specific phobia module of the ADIS-IV was administered to assess the presence and severity of a current diagnosis of dental phobia. Various aspects of dental phobia were assessed using the specific phobia module of the ADIS-IV. Interviewers assessed participants' anxiety and avoidance of dental procedures on scales that ranged from 0 (none) to 8 (very severe). They also rated patients' overall distress and impairment due to their dental phobia symptoms and assigned a clinician's severity rating (CSR) that also ranged from 0 (none) to 8 (very severe); a CSR \> 4 indicated that the participant met criteria for diagnosis of dental phobia.

Outcome measures

Outcome measures
Measure
Immediate Treatment
n=52 Participants
Before the intervention, participants completed self-report questionnaires and a telephone diagnostic interview. Participants in the immediate treatment group were asked to come in 1.5 hours before a previously scheduled dental appointment to complete the computerized cognitive-behavioral therapy dental anxiety intervention (C-CBT). The C-CBT consisted of a single-session, one-hour computerized intervention that assisted the participant in building skills for managing his or her dental anxiety. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Waiting List Control
n=63 Participants
Before their dental appointments, participants completed self-report questionnaires and a telephone diagnostic interview. Waiting list control participants attended their scheduled dental appointment without receiving the computerized cognitive-behavioral therapy dental anxiety intervention but were offered the opportunity to receive the same intervention following all of their study assessments. One month after the dental appointment, participants were contacted by phone and asked to complete follow-up assessments.
Change in Avoidance Rating for Specific Phobia Module of Anxiety Disorders Interview Schedule for DSM-IV
Baseline
4.6 units on a scale
Standard Error 0.31
3.9 units on a scale
Standard Error 0.32
Change in Avoidance Rating for Specific Phobia Module of Anxiety Disorders Interview Schedule for DSM-IV
One month follow up
1.3 units on a scale
Standard Error 0.31
1.0 units on a scale
Standard Error 0.29

Adverse Events

Immediate Treatment

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Waiting List Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Marisol Tellez M. BDS, MPH, Ph.D

Maurice H. Kornberg School of Dentistry, Temple University

Phone: 215-707-1773

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place