Cargando…

A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS?

OBJECTIVES: The annual incidence of hip fracture is 620 000 in the European Union. The cost of this clinical problem has been estimated at 1.75 million disability-adjusted life years lost, equating to 1.4% of the total healthcare burden in established market economies. Recent guidance from The Natio...

Descripción completa

Detalles Bibliográficos
Autores principales: Huxley, C., Achten, J., Costa, M. L., Griffiths, F., Griffin, X. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2016
Materias:
Hip
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062090/
https://www.ncbi.nlm.nih.gov/pubmed/27765735
http://dx.doi.org/10.1302/2046-3758.510.BJR-2015-0008.R1
_version_ 1782459708969320448
author Huxley, C.
Achten, J.
Costa, M. L.
Griffiths, F.
Griffin, X. L.
author_facet Huxley, C.
Achten, J.
Costa, M. L.
Griffiths, F.
Griffin, X. L.
author_sort Huxley, C.
collection PubMed
description OBJECTIVES: The annual incidence of hip fracture is 620 000 in the European Union. The cost of this clinical problem has been estimated at 1.75 million disability-adjusted life years lost, equating to 1.4% of the total healthcare burden in established market economies. Recent guidance from The National Institute for Health and Clinical Excellence (NICE) states that research into the clinical and cost effectiveness of total hip arthroplasty (THA) as a treatment for hip fracture is a priority. We asked the question: can a trial investigating THA for hip fracture currently be delivered in the NHS? METHODS: We performed a contemporaneous process evaluation that provides a context for the interpretation of the findings of WHiTE Two – a randomised study of THA for hip fracture. We developed a mixed methods approach to situate the trial centre within the context of wider United Kingdom clinical practice. We focused on fidelity, implementation, acceptability and feasibility of both the trial processes and interventions to stakeholder groups, such as healthcare providers and patients. RESULTS: We have shown that patients are willing to participate in this type of research and that surgeons value being part of a team that has a strong research ethos. However, surgical practice does not currently reflect NICE guidance. Current models of service delivery for hip fractures are unlikely to be able to provide timely total hip arthroplasty for suitable patients. CONCLUSIONS: Further observational research should be conducted to define the population of interest before future interventional studies are performed. Cite this article: C. Huxley, J. Achten, M. L. Costa, F. Griffiths, X. L. Griffin. A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS? Bone Joint Res 2016;5:444–452. DOI: 10.1302/2046-3758.510.BJR-2015-0008.R1.
format Online
Article
Text
id pubmed-5062090
institution National Center for Biotechnology Information
language English
publishDate 2016
record_format MEDLINE/PubMed
spelling pubmed-50620902016-10-14 A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS? Huxley, C. Achten, J. Costa, M. L. Griffiths, F. Griffin, X. L. Bone Joint Res Hip OBJECTIVES: The annual incidence of hip fracture is 620 000 in the European Union. The cost of this clinical problem has been estimated at 1.75 million disability-adjusted life years lost, equating to 1.4% of the total healthcare burden in established market economies. Recent guidance from The National Institute for Health and Clinical Excellence (NICE) states that research into the clinical and cost effectiveness of total hip arthroplasty (THA) as a treatment for hip fracture is a priority. We asked the question: can a trial investigating THA for hip fracture currently be delivered in the NHS? METHODS: We performed a contemporaneous process evaluation that provides a context for the interpretation of the findings of WHiTE Two – a randomised study of THA for hip fracture. We developed a mixed methods approach to situate the trial centre within the context of wider United Kingdom clinical practice. We focused on fidelity, implementation, acceptability and feasibility of both the trial processes and interventions to stakeholder groups, such as healthcare providers and patients. RESULTS: We have shown that patients are willing to participate in this type of research and that surgeons value being part of a team that has a strong research ethos. However, surgical practice does not currently reflect NICE guidance. Current models of service delivery for hip fractures are unlikely to be able to provide timely total hip arthroplasty for suitable patients. CONCLUSIONS: Further observational research should be conducted to define the population of interest before future interventional studies are performed. Cite this article: C. Huxley, J. Achten, M. L. Costa, F. Griffiths, X. L. Griffin. A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS? Bone Joint Res 2016;5:444–452. DOI: 10.1302/2046-3758.510.BJR-2015-0008.R1. 2016-10-11 /pmc/articles/PMC5062090/ /pubmed/27765735 http://dx.doi.org/10.1302/2046-3758.510.BJR-2015-0008.R1 Text en © 2016 Griffin et al. This is an open-access article distributed under the terms of the Creative Commons Attributions licence (CC-BY-NC), which permits unrestricted use, distribution, and reproduction in any medium, but not for commercial gain, provided the original author and source are credited.
spellingShingle Hip
Huxley, C.
Achten, J.
Costa, M. L.
Griffiths, F.
Griffin, X. L.
A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS?
title A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS?
title_full A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS?
title_fullStr A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS?
title_full_unstemmed A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS?
title_short A process evaluation of the WHiTE Two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: Can a trial investigating total hip arthroplasty for hip fracture be delivered in the NHS?
title_sort process evaluation of the white two trial comparing total hip arthroplasty with and without dual mobility component in the treatment of displaced intracapsular fractures of the proximal femur: can a trial investigating total hip arthroplasty for hip fracture be delivered in the nhs?
topic Hip
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062090/
https://www.ncbi.nlm.nih.gov/pubmed/27765735
http://dx.doi.org/10.1302/2046-3758.510.BJR-2015-0008.R1
work_keys_str_mv AT huxleyc aprocessevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT achtenj aprocessevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT costaml aprocessevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT griffithsf aprocessevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT griffinxl aprocessevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT huxleyc processevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT achtenj processevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT costaml processevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT griffithsf processevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs
AT griffinxl processevaluationofthewhitetwotrialcomparingtotalhiparthroplastywithandwithoutdualmobilitycomponentinthetreatmentofdisplacedintracapsularfracturesoftheproximalfemurcanatrialinvestigatingtotalhiparthroplastyforhipfracturebedeliveredinthenhs