The Journey to Success
In August 2021, we embarked on an ambitious journey: recruiting 1,180 patients to the RETURN trial within 12 months. This followed a successful feasibility study that helped us refine our approach. The trial aimed to assess whether an intervention could help patients return to routine dental care after an urgent dental appointment. Half of the participants received the RETURN intervention, while the other half did not. By comparing these groups, we aimed to determine the intervention’s effectiveness.
Reaching our goal took a little longer than expected – 4 months instead of 12 – but the hard work and dedication of our teams made it possible. Here’s how we did it
August 2021 – Month 1: A Milestone Beginning
August 18, 2021, marked a significant milestone—the first patient was recruited! We started with two sites:
- Liverpool Dental Hospital
- Hale Road Dental Practice
By the end of the month, 11 patients had joined the trial, and six dental nurses were trained to support recruitment and intervention delivery.
September 2021 – Month 2: Growing the Team
Two more dental practices joined:
- Little Sutton Dental Practice
- Talking Teeth, Widnes
By the end of the month, we had recruited 52 participants. We spent time working with practices, providing on-site training and support to dental nurses.
We heard from our lovely nurse Amy who works at Liverpool Dental Hospital about how she was finding her work on RETURN, and this is a quote from what she had to say:
“I like having more interaction with the patients, and the other nurses as well say that they enjoy having more time with the patients. If you told me two weeks ago that I would feel this confident already I wouldn’t have believed it. Now, already, I feel like I have really got the hang of it!”
October 2021 – Month 3: Building Momentum
Three new practices came on board:
- Talking Teeth, St Helens
- Garston Dental Practice
- Smart Dental, Croxteth
By the end of October, we had recruited 130 patients, and two nurses were certified to independently deliver the intervention.
We heard from Anna who works at Hale Road Dental Practice, and here is a quote about what she thought about working on RETURN with us:
“I have really enjoyed learning about trials, and how important they are. I have never been part of one before, and I didn’t know much about them. Now I realise how essential they are and how important it is to help.
I enjoy listening to the patients and trying to help. I really like working on the project as I enjoy the way it helps you to engage with patients.”
November 2021 – Month 4: A Big Leap Forward
Recruitment surged to 222 patients! Three more nurses were signed off to deliver the intervention, and three new practices joined:
- Martin’s Lane, Wallasey
- Smart Dental, Poulton
- Rodericks, Liverpool
In addition to recruiting patients, the team signed off of three more nurses to deliver the RETURN Intervention independently. We were so proud of Leah from Talking Teeth Dental Practice, Kerry from the Liverpool Dental Hospital, and Charlotte from Little Sutton Dental Practice for achieving this!
This month we heard from the brilliant Charlotte who was a nurse working at Little Sutton Dental Practice, and this is a quote about how she felt about working on the RETURN Project with us:
“There are so many aspects to working in a dental surgery, and RETURN has given me the opportunity to talk to patients much more, which I really enjoy. I think that RETURN has been great in encouraging nurses to think about how the patients are feeling. It has been really helpful to remind ourselves of issues patients have about coming to the dentist. I think it is easy to forget, and that not everyone thinks how we do about dental visits and not everyone is happy to go to the dentist.”
December 2021 – Month 5: Facing Challenges
Despite the Christmas break and the Omicron COVID-19 wave, we reached 281 participants. Our team remained committed, supporting practices and ensuring recruitment continued.
Our RETURN team member Stacey had this to say about her work in helping to recruit patients and to support dental nurses at the dental practices taking part in the research:
“It makes me happy knowing that we are really helping people and changing the way they think about their dental care. When filling out Q2 one patient said to me, ‘oh well I’ve changed my answer now after our chat’, and being named in someone’s plan as them ‘no longer having a barrier thanks to Stacey’ was a particular highlight as it really cemented to me that we are making a difference to people.”
January 2022 – Month 6: Halfway Through
January 2022 marked the halfway point of our recruitment window. This month we welcomed two more sites:
- Helsby Dental Practice
- Atlantic Dental
We also added to our growing team of signed-off nurses. Debbie in Hale Road, Caroline in Helsby and Ben in Martin’s Lane were all signed off to be able to deliver the intervention independently and we were very proud of this achievement.
At this stage, we had recruited 368 patients.
At the six-month mark we also started our first follow-up contacts with the patients in our trial. This was our first opportunity to speak with the patients involved in the trial to see how they had been getting on, and to find out if the RETURN intervention had been useful to them. The team were really excited to be chatting with our trial participants.
This month we spoke to our nurse Leah, who worked at Talking Teeth, and this is a quote from what she thought about her experience of working on the RETURN Project with us:
“I loved the idea of the RETURN project at once. I am up for anything and saw it as another notch on my nurse’s belt as I love learning and doing new things. I quickly realised I needed to learn the processes involved and then it would let me do what I love doing – talking to patients. I love my job and I am very patient-centred. What I love about RETURN is this is an opportunity for nurses to have a lead role.”
February 2022 – Month 7: Going Strong
We welcomed two new sites to the RETURN Team, bring the total number of active sites to 14:
- Smart Dental Edge Hill
- Smart Dental Sefton
With the effects of the COVID Omicron variant outbreak now slowing down, recruitment picked up. By the end of February, recruitment stood at 492 patients Our two new sites proved extremely valuable, and large numbers of patients were recruited from these very busy dental practices.
This month the wonderful Debbie from Hale Road Dental Practice had this to say about her involvement in the RETURN Project:
“I have been a dental nurse for over 13 years and it felt a bit weird to be learning new things again, but I enjoy it and it was good to pick up new skills. The RETURN project has opened my eyes to the amount of dental knowledge in the community. There are so many different reasons why people do not go to the dentist. Many of the patients don’t know half of the support we can offer, and they don’t realise how much it can help to speak to the nurses to learn more about the procedures.”
March 2022 – Month 8: Over Halfway To Target!
With 12 sites actively recruiting patients to the trial every week, this month our recruitment reached 626 patients – which is quite an achievement within the space of 8 months!
The lovely Caroline from Helsby Dental Practice had this to say about her experience of the trial:
“I absolutely love delivering RETURN, this project is so valuable for the future. Being signed off has given me more confidence and I’m much better at talking to patients. The project makes life easier for the patient – when they go to the dentist they’re really nervous, then they see the intervention and talk through it with you and it all gets easier. Don’t be scared of the processes, it all just clicks. Doing what you do every day makes it work so well. It is a pleasure to be part of such a big project in Merseyside; I am thrilled to be part of it. We are helping people so much and it is so lovely.”
April 2022 – Month 9: Steady Progress
Recruitment was still going strong and by the end of April we had reached a recruitment number of 709 patients.
Dental practices were still very engaged with us, and our team were making regular visits to different dental sites to offer support if needed. The dental nurses involved were reporting that they were still enjoying being part of the research , and in our follow-ups, patients were also reporting that they had enjoyed taking part too.
This month, over very own senior dental nurse Julie spoke to us about how she was finding being part of our research project:
“I’ve so enjoyed being part of this project, getting to meet lots of patients and also being able to visit lots of different nurses and dental practices to support them with getting signed off so they can deliver independently. I’ve found it so rewarding, and I’ve loved being able to have the opportunity to spend longer with patients to find out more about their barriers to visiting the dentist.”
May 2022 – Month 10: A Bumper Month!
May was a very busy months for the trial, with lots of patients agreeing to take part. Our recruitment number was up to 813.
We also signed another nurse off to recruit to the trial independently, taking the total to 14 dental nurses recruiting across Merseyside and Cheshire. Our dedicated team members were visiting sites, supporting nurses and recruiting patients themselves throughout the recruitment period too in order to boost trial recruitment numbers, and to provide support to our wonderful dental nurses in their practices.
This month, our own nurse Amy talked about her positive experience of the trial, and this is what she had to say:
“One of my favourite things about my role is that I get to visit lots of different dental practices as well as the Dental Hospital, and that I get to work with all of the lovely people within those dental teams who support the research, and who are always willing to help me in any way they can. I feel that I am more aware of the many issues facing our patients and I am really enjoying helping them.”
June 2022 – Month 11: Busy Busy
The month of June saw a further 108 patients recruited into the RETURN trial, bringing the running the total to 921 patients recruited!
This was another very busy month, with our target recruitment number edging ever closer. However summer months are often much quieter for research, and with 259 patients still to recruit, meeting our target felt like a tall order.
During the month of June, the RETURN research team were also preparing to start their next wave of follow-up calls for those patients reaching their 12-month anniversary. This would mean that 6-month and 12-month follow-ups were being conducted at the same time as recruiting…busy busy busy!
This month, we spoke to the lovely Kelly who worked at the Liverpool Dental Hospital, and here is a quote from what she said to us about taking part in RETURN:
“I have been a dental nurse for over 14 years and became interested in the RETURN Project as it sounded to me like something different and a bit of a challenge which appealed to me. When I was signed off, I have to admit, it brought tears to my eyes. We see so many patients here at the Dental Hospital, but you just never know the difficulties that people are having in their daily lives. Now when I am working as a dental nurse within my ordinary role, away from Return I do think that I am even more thoughtful and inclusive with the patients I work with now.”
July 2022 – Month 12: Our Original Target
As predicted recruitment during the month of July slowed down, with 997 patients recruited by the end of the month.
A decision was made to extend our recruitment period with the 14 dental practices we had on board for a further 4-months to allow us time to recruit our final 183 patients.
The 12-month follow-up of patients was in full-swing now, and it was wonderful to see how our patients were getting on a year from signing up to taking part in the research. Our whole team says that speaking to our participants again is one of the best parts of our job!
August 2022 – Month 13: Slow and Steady
Recruitment numbers were slow and steady throughout the month of August with lots of dental team and RETURN team members taking annual leave around this time. By the end of August 2022 we had recruited 1081 patients, leaving just 99 to go!
September 2022 – Month 14: we did it!
September 2022 was the 14th and final month of recruitment to the RETURN trial. Everyone involved put in a final push to get us over the line! The last patient was recruited on the 29th September 2022, reaching our target just six weeks behind our original deadline.
Victoria Lowers, the RETURN Programme Manager, had this to say about the amazing effort put in by all the dental teams as well as the RETURN team working behind the scenes:
“It has been an absolute pleasure and a privilege to work with so many wonderful people over the past few years from training, to research set up and finally seeing recruitment finished. I have met some brilliant people along the way and hope to have the opportunity of conducting more research with our wonderful dental teams again in the future”
Now that recruitment is complete, focus will turn to the study follow-up. This will end in April 2024. The RETURN team are looking forward to speaking to all of the very kind patients who agreed to give their time up to help us with this research.
The RETURN team would also like to say a very warm thank you to each and every dental team member who learned new research skills and delivered our trial within their practices. We could not have done it without you!
