Update Interdisciplinary Clinical Practice Guideline for Patients with Cleft Lip and Palate at Prenatal Until 5 Years
Keywords:
Clinical Practice guideline; Cleft lip and palate; Interdisciplinary team; Tawanchai CenterAbstract
Background and Objective: Patients with cleft lip and palate require long-term care from interdisciplinary team. The important phase of treatment is pre-natal until 5 years. Update clinical practice guideline therefore important.
Methods: This participation action research were performed by 30 members of interdisciplinary team in Tawanchai Center which comprises of 10 disciplines. Participated in analyzing the problem and updating the guideline by 24 members, 2 times, sending the guideline to 3 disciplines which are pediatricians, obstetricians and psychiatrists not attending the meeting to give suggestions. And content validity was checked by 5 experts with updated guidelines applied and clinical outcome evaluation. Study was conducted for 4 months (January - April 2019), summarizing data and content analysis.
Results: It was found that during the 6 weeks before pregnancy, update by giving folic acid, between the ages of 3-6 months, adding the support for the shape of the nose after Cheiloplasty by nasal creator device. Consultation for pediatric dentists and send for the assessment, promoting language and speech development no. 1, cancel follow-up treatment according to the online registration system. Between the ages of 10-18 months, adding evaluating the development of alveolar and maxilla with oral health before palatoplasty, between the ages of 1 and a half-3 years and 4-5 years. Adding evaluation of the middle ear, repeated every 3 months. If not otitis media, repeat every 6 months until the age of 7 years until Eustachian work well. And cancel follow-up treatment according to the online registration system.
Conclusions: The updated guideline covers all interdisciplinary team care, from pre-natal until 5 years and evaluating results over the 5 years. There most beneficial to patients, and could be applied to other centers that has a similar context.
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