Informed Consent Statement

You are being asked to participate in a research project.

A student and faculty member at Drake University College of Pharmacy & Health Sciences in Des Moines, Iowa want your help by participating in a research project. The goal of this project is to describe dentist and dental hygienist practices in Iowa in making recommendations regarding antithrombotic management around the time of dental procedures and to provide education about current clinical recommendations. If you are interested, please read on, consider if you would like to participate, and click the link at the bottom of this webpage.

What is the purpose of this research?

The purpose of this study is to understand current recommendations made by dentists and dental hygienists to patients regarding anticoagulant and antiplatelet medications. Those recommendations will be compared to the current guidelines from various professional organizations. Also, the impact of education on the future recommendations by these professionals will be examined.

What will participating in this study involve?

If you agree to participate in this study, you will:

  1. take a short online survey (18 total questions). This survey will ask you questions regarding your experience, preferences, and beliefs regarding anticoagulants and antiplatelet drugs as well as a few background questions. A majority of the questions are multiple choice or ranking questions but you will also have the opportunity give more feedback with some questions.
  2. A short educational presentation will then be shown to inform you about the current, best recommendations.
  3. A follow up survey (7 total questions) will then be administered to observe impact of the educational presentation.


How long will it take for me to participate?

We anticipate that participation will take no longer than 25 minutes, although it may take more or less time depending on your responses to the questions.

What are the RISKS of participating in this study?

There will be minimal risk associated with participating in this. Although this study is only collecting anonymous survey data, there is a small chance based on your responses your information could be identifiable. To minimize this risk, researchers will follow standard procedures to keep your responses private. We will not link any of your responses to your contact information. Only members of the research team involved in the project from Drake will have access to your individual survey responses. There may be reports, presentations, or publications as a result of this project, but neither your name, nor any personally identifiable information will be used.

In addition, if you may become upset, anxious or embarrassed about your performance on some questions, you may skip any questions you do not wish to complete.

What are the BENEFITS of participating in this study?

After completion of the study, you may enter a drawing to win one of two available Apple iPad Minis. One dentist and one dental hygienist will be selected at random to receive a prize. You will be asked to provide your name and either your phone number or your email address if you wish to enter the drawing. We will not be able to link your contact information to your responses and will not reveal your contact information to anyone.  Participation is not a guarantee that you will win. You do not have to enter the drawing for the iPads if you do not wish to do so.

In addition, participants will benefit by learning the current recommendations and best practices for using of anticoagulant and antiplatelet drugs at the time of dental appointments. This may improve the safety of patients you see who are taking these drugs.

What will happen if you choose not to participate in this study?

Your participation in this project is completely voluntary. If you decide not to participate in this study, it will not affect your relationship with Drake University.

What will happen if you decide to withdraw from the study?

At any time during the study you can change your mind and withdrawal from the study. There are no penalties for withdrawing from the study; however, you must enter your contact information at the end of the survey to be considered to the iPad drawing.

Whom should I contact if I have any questions?

If you have any questions or concerns regarding your rights as a participant in this study, please contact the principal investigator, Dr. Andrew Miesner, PharmD, BCPS at (515) 282-5680 or by email at Additionally, you can also ask questions or communicate any concerns to the Drake University Investigational Review Board at (515) 271-3472 or by email at

Please print this page to save for your records. 

You may also CLICK HERE to save a copy.
By clicking on the link below you indicate that you have read this consent form, had an opportunity to ask any questions about your participation in this study and voluntarily consent to participate.



I don’t want to participate.