Bridging the knowledge and self-reported practice of geriatric dental prescribing: a multi-region cross-sectional survey of Indian dental providers

Population ageing has increased the complexity of dental prescribing because of multimorbidity, polypharmacy, age-related physiological changes, and increased susceptibility to adverse drug events among older adults. Although knowledge deficits in geriatric pharmacotherapy among dentists have been documented, whether existing knowledge is reflected in self-reported prescribing behaviour remains poorly understood. This study aimed to quantify the discrepancy between knowledge and self-reported prescribing behaviour in geriatric dental pharmacotherapy and to describe demographic and professional factors associated with a larger knowledge–practice score difference among Indian dental providers. A total of 1150 participants were included. The originally reported mean knowledge score was 64.0% (SD 22.4), and the mean self-reported practice score was 51.6% (SD 19.2), giving a mean difference of 12.4 percentage points (95% CI 11.4–13.4). Reported score differences were larger among trainees than among clinicians with more than 5 years of experience. Attitude scores had a numerically stronger cross-sectional correlation with practice scores than knowledge scores did (Spearman ρ = 0.51 and 0.29, respectively); the difference between correlations was not formally tested. The questionnaire indicated a difference between knowledge and self-reported prescribing practice scores. This difference is not a validated measure of implementation failure or audited prescribing quality. Associations with attitudes and experience are hypothesis-generating; the study cannot establish that changing knowledge, attitudes or experience changes prescribing behaviour.