Literature Collection

Background: Interprofessional collaboration is vital for comprehensive, patient-centered care. Despite growing recognition of oral-systemic health links, the integration of dentists into healthcare teams remains limited. This scoping review mapped existing evidence on dental professionals' roles within interprofessional healthcare, identifying key benefits, barriers, and facilitators. Methods: A systematic search of PubMed, SCOPUS, and Web of Science identified English-language studies (2014 to 2024) focused on collaboration between dental and non-dental providers. Studies addressing oral-systemic health without team-based integration were excluded. Screening and data charting followed the PRISMA-ScR framework using JBI data extraction and critical appraisal tools. Data were synthesized thematically by collaboration model, outcomes, and influencing factors. Results: Nine studies met the inclusion criteria. Integrating dental professionals into healthcare teams improved patient outcomes, quality of life, and satisfaction. Effective models included nurse practitioner-dentist partnerships and medical-dental collaboration in pediatrics and chronic disease care. Barriers included poor communication, lack of interoperable electronic health records, role ambiguity, and limited interprofessional training. Key facilitators were supportive policies, integrated care structures, professional education, and strong team communication. Conclusions: Integrating dentists into interprofessional teams enhances healthcare delivery and patient outcomes. However, significant barriers remain. Addressing communication gaps, implementing shared health records, and expanding interprofessional education are essential steps toward more cohesive care. Future research should evaluate scalable integration frameworks and incorporate patient perspectives to inform team-based care.

Digital cognitive behavioural therapy for insomnia has been developed to increase capacity and scalability for patients with insomnia, but implementation in primary care remains limited. The aim of the trial was to evaluate the implementation of digital insomnia therapy into primary care practice for patients with insomnia. We conducted a single-arm feasibility trial of digital behavioural therapy for insomnia (SleepFix) providing sleep restriction therapy with insomnia patients in primary care. Healthcare professionals (comprising General Practitioners, community pharmacists and nurses) were enrolled into the trial and, when deemed clinically appropriate, prescribed SleepFix to patients with insomnia. The primary outcome was uptake assessed by the number of downloads of SleepFix. Interviews with primary care healthcare professionals explored their attitudes towards implementing/using insomnia digital therapeutics in clinical practice, and patients about their experiences with SleepFix. Insomnia symptoms, mood and sleep quality were measured before and after the trial. This trial was prospectively registered (ACTRN12620000055909). Thirty healthcare professionals and 105 patients were enrolled into the trial. Fourteen healthcare professionals administered at least one insomnia digital therapeutic prescription between November 2021 and March 2022. Fifty patients downloaded and used SleepFix (47.6% uptake). In post-trial interviews, healthcare professionals felt they could incorporate digital sleep health into clinical practice and patients found SleepFix acceptable. There were significant improvements in insomnia symptoms, mood and sleep quality at week 6 (all p < 0.05). This trial shows a real-world implementation of a digital insomnia therapy into primary care that could provide a framework for prescribing digital sleep interventions.

Integrating exercise prescriptions with medication management represents a novel approach for enhancing health and function, optimising medication effectiveness, and reducing adverse drug reactions and polypharmacy in older adults (ie, those aged ≥60 years). This Personal View highlights the need for a comprehensive assessment of lifestyle, diagnoses, geriatric syndromes, and medications with an emphasis on fully incorporating exercise treatment into geriatric care. Exercise is an alternative to less effective or unsafe medications for many conditions, including depression, anxiety, insomnia, osteoarthritis, and dementia. Exercise is an important adjunct to pharmacotherapy for many common chronic conditions such as coronary artery disease, heart failure, diabetes, osteoporosis, cancer, and chronic obstructive pulmonary disease. Adding exercise to drug management can mitigate adverse drug reactions, enhance medication compliance, and reduce the adverse effects of sedentary behaviour and ageing processes on chronic disease expression. Targeted exercise programmes have also been shown to ameliorate drug-induced side-effects, including anorexia, falls, sarcopenia, osteoporosis, and orthostatic hypotension, and to overcome constraints such as reduced aerobic fitness, balance impairment, and muscle atrophy due to some medications. Health-care professionals require additional training and support to ensure that exercise assumes a key, central role in older adults with multimorbidity and polypharmacy, as supported by the current literature. This Personal View describes practical approaches to incorporating exercise into clinical practice as a step towards an integrated geriatric care model, with the ultimate aim of increasing health span and minimising disability.

This Grantmakers in Health Bulletin article, authored by NYSHealth Senior Program Director Jacqueline Martinez Garcel and NYSHealth Chief Program Learning Officer Kelly Hunt, examines the lack of integrated care for people with co-occurring mental health and substance use disorders and how NYSHealth has supported efforts to transform the systems of care for New Yorkers coping with both conditions.Care for people with co-occurring conditions remains terribly fragmented. Three separate systems exist - health, mental health, and substance use services - to care for each individual problem, each one with its own set of norms, culture, regulations, reimbursement process, and accountability. These siloed systems of care have led to a revolving door for people seeking help. To help transform the systems of care, NYSHealth established the Center for Excellence in Integrated Care (the Center), the first-of-its-kind in New York State. As of the end of 2012, the Center has worked with more than 600 mental health and substance use outpatient sites to help them fully integrate services for patients with co-occurring disorders. The article looks at the approach and impact of integrating care across the two systems, the outcomes to date, and how this can be a model for care management teams.