Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention.
Authors
Crawford-Manning, Fay
Cottrell, Elizabeth
Fleming, Jane
Leyland, Sarah
Edwards, John
Clark, Emma M
Thomas, Simon
Chapman, Stephen
Gidlow, Christopher
Iglesias, Cynthia P
Horne, Robert
O'Neill, Terence W
Mallen, Christian
Jinks, Clare
Publication Date
2021-03-24Journal Title
Arch Osteoporos
ISSN
1862-3522
Publisher
Springer Science and Business Media LLC
Volume
16
Issue
1
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Bullock, L., Crawford-Manning, F., Cottrell, E., Fleming, J., Leyland, S., Edwards, J., Clark, E. M., et al. (2021). Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention.. Arch Osteoporos, 16 (1) https://doi.org/10.1007/s11657-021-00913-w
Abstract
UNLABELLED: 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.
Keywords
Original Article, Osteoporosis, Fracture Liaison Services, Delphi survey, Intervention development, Consultation, iFraP
Identifiers
s11657-021-00913-w, 913
External DOI: https://doi.org/10.1007/s11657-021-00913-w
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333034
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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