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Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention
SUMMARY: Fracture Liaison Services are recommended to deliver best practice in secondary fracture prevention. This modified Delphi survey, as part of the iFraP (Improving uptake of Fracture Prevention drug Treatments) study, provides consensus regarding tasks for clinicians in a model Fracture Liais...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer London
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989712/ https://www.ncbi.nlm.nih.gov/pubmed/33761007 http://dx.doi.org/10.1007/s11657-021-00913-w |
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author | Bullock, Laurna Crawford-Manning, Fay Cottrell, Elizabeth Fleming, Jane Leyland, Sarah Edwards, John Clark, Emma M Thomas, Simon Chapman, Stephen Gidlow, Christopher Iglesias, Cynthia P Protheroe, Joanne Horne, Robert O’Neill, Terence W Mallen, Christian Jinks, Clare Paskins, Zoe |
author_facet | Bullock, Laurna Crawford-Manning, Fay Cottrell, Elizabeth Fleming, Jane Leyland, Sarah Edwards, John Clark, Emma M Thomas, Simon Chapman, Stephen Gidlow, Christopher Iglesias, Cynthia P Protheroe, Joanne Horne, Robert O’Neill, Terence W Mallen, Christian Jinks, Clare Paskins, Zoe |
author_sort | Bullock, Laurna |
collection | PubMed |
description | SUMMARY: Fracture Liaison Services are recommended to deliver best practice in secondary fracture prevention. This modified Delphi survey, as part of the iFraP (Improving uptake of Fracture Prevention drug Treatments) study, provides consensus regarding tasks for clinicians in a model Fracture Liaison Service consultation. PURPOSE: The clinical consultation is of pivotal importance in addressing barriers to treatment adherence. The aim of this study was to agree to the content of the ‘model Fracture Liaison Service (FLS) consultation’ within the iFraP (Improving uptake of Fracture Prevention drug Treatments) study. METHODS: A Delphi survey was co-designed with patients and clinical stakeholders using an evidence synthesis of current guidelines and content from frameworks and theories of shared decision-making, communication and medicine adherence. Patients with osteoporosis and/or fragility fractures, their carers, FLS clinicians and osteoporosis specialists were sent three rounds of the Delphi survey. Participants were presented with potential consultation content and asked to rate their perception of the importance of each statement on a 5-point Likert scale and to suggest new statements (Round 1). Lowest rated statements were removed or amended after Rounds 1 and 2. In Round 3, participants were asked whether each statement was ‘essential’ and percentage agreement calculated; the study team subsequently determined the threshold for essential content. RESULTS: Seventy-two, 49 and 52 patients, carers and clinicians responded to Rounds 1, 2 and 3 respectively. One hundred twenty-two statements were considered. By Round 3, consensus was reached, with 81 statements deemed essential within FLS consultations, relating to greeting/introductions; gathering information; considering therapeutic options; eliciting patient perceptions; establishing shared decision-making preferences; sharing information about osteoporosis and treatments; checking understanding/summarising; and signposting next steps. CONCLUSIONS: This Delphi consensus exercise has summarised for the first time patient/carer and clinician consensus regarding clearly defined tasks for clinicians in a model FLS consultation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11657-021-00913-w. |
format | Online Article Text |
id | pubmed-7989712 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer London |
record_format | MEDLINE/PubMed |
spelling | pubmed-79897122021-03-25 Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention Bullock, Laurna Crawford-Manning, Fay Cottrell, Elizabeth Fleming, Jane Leyland, Sarah Edwards, John Clark, Emma M Thomas, Simon Chapman, Stephen Gidlow, Christopher Iglesias, Cynthia P Protheroe, Joanne Horne, Robert O’Neill, Terence W Mallen, Christian Jinks, Clare Paskins, Zoe Arch Osteoporos Original Article SUMMARY: Fracture Liaison Services are recommended to deliver best practice in secondary fracture prevention. This modified Delphi survey, as part of the iFraP (Improving uptake of Fracture Prevention drug Treatments) study, provides consensus regarding tasks for clinicians in a model Fracture Liaison Service consultation. PURPOSE: The clinical consultation is of pivotal importance in addressing barriers to treatment adherence. The aim of this study was to agree to the content of the ‘model Fracture Liaison Service (FLS) consultation’ within the iFraP (Improving uptake of Fracture Prevention drug Treatments) study. METHODS: A Delphi survey was co-designed with patients and clinical stakeholders using an evidence synthesis of current guidelines and content from frameworks and theories of shared decision-making, communication and medicine adherence. Patients with osteoporosis and/or fragility fractures, their carers, FLS clinicians and osteoporosis specialists were sent three rounds of the Delphi survey. Participants were presented with potential consultation content and asked to rate their perception of the importance of each statement on a 5-point Likert scale and to suggest new statements (Round 1). Lowest rated statements were removed or amended after Rounds 1 and 2. In Round 3, participants were asked whether each statement was ‘essential’ and percentage agreement calculated; the study team subsequently determined the threshold for essential content. RESULTS: Seventy-two, 49 and 52 patients, carers and clinicians responded to Rounds 1, 2 and 3 respectively. One hundred twenty-two statements were considered. By Round 3, consensus was reached, with 81 statements deemed essential within FLS consultations, relating to greeting/introductions; gathering information; considering therapeutic options; eliciting patient perceptions; establishing shared decision-making preferences; sharing information about osteoporosis and treatments; checking understanding/summarising; and signposting next steps. CONCLUSIONS: This Delphi consensus exercise has summarised for the first time patient/carer and clinician consensus regarding clearly defined tasks for clinicians in a model FLS consultation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11657-021-00913-w. Springer London 2021-03-24 2021 /pmc/articles/PMC7989712/ /pubmed/33761007 http://dx.doi.org/10.1007/s11657-021-00913-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Bullock, Laurna Crawford-Manning, Fay Cottrell, Elizabeth Fleming, Jane Leyland, Sarah Edwards, John Clark, Emma M Thomas, Simon Chapman, Stephen Gidlow, Christopher Iglesias, Cynthia P Protheroe, Joanne Horne, Robert O’Neill, Terence W Mallen, Christian Jinks, Clare Paskins, Zoe Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention |
title | Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention |
title_full | Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention |
title_fullStr | Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention |
title_full_unstemmed | Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention |
title_short | Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention |
title_sort | developing a model fracture liaison service consultation with patients, carers and clinicians: a delphi survey to inform content of the ifrap complex consultation intervention |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989712/ https://www.ncbi.nlm.nih.gov/pubmed/33761007 http://dx.doi.org/10.1007/s11657-021-00913-w |
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