Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention

Laurna Bullock, Fay Crawford-Manning, Elizabeth Cottrell, Jane Fleming, Sarah Leyland, John Edwards, Emma M Clark, Simon Thomas, Stephen Chapman, Christopher Gidlow, Cynthia P Iglesias, Joanna Protheroe, Robert Horne, Terence W O’Neill, Christian Mallen, Clare Jinks, Zoe Paskins

Research output: Contribution to journalArticle (Academic Journal)peer-review

6 Downloads (Pure)

Abstract

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.
Original languageEnglish
Article number58 (2021)
Number of pages17
JournalArchives of Osteoporosis
Volume16
Issue number1
DOIs
Publication statusPublished - 24 Mar 2021

Keywords

  • Osteoporosis
  • Fracture Liaison Services
  • Delphi survey
  • Intervention development
  • Consultation
  • iFraP

Fingerprint Dive into the research topics of 'Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention'. Together they form a unique fingerprint.

Cite this