Improving patients’ experiences of diagnosis and treatment of vertebral fracture: co-production of knowledge sharing resources

Sarah E Bennett*, Rachael Gooberman-Hill, Emma M Clark, Zoe Paskins, Nicola Walsh, Sarah Drew

*Corresponding author for this work

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


Osteoporosis involves changes to bones that makes them prone to fracture. The most common osteoporotic fracture is vertebral, in which one or more spinal vertebrae collapse. People with vertebral fracture are at high risk of further fractures, however around two-thirds remain undiagnosed. The National Institute for Health and Care Excellence (NICE) recommends bone protection therapies to reduce this risk. This study aimed to co-produce a range of knowledge sharing resources, for healthcare professionals in primary care and patients, to improve access to timely diagnosis and treatment.

This study comprised three stages:
1.In-depth interviews with primary care healthcare professionals (n=21) and patients with vertebral fractures (n=24) to identify barriers and facilitators to diagnosis and treatment.
2.A taxonomy of barriers and facilitators to diagnosis were presented to three stakeholder groups (n=18), who suggested ways of identifying, diagnosing and treating vertebral fractures. Fourteen recommendations were identified using the nominal group technique.
3.Two workshops were held with stakeholders to co-produce and refine the prototype knowledge sharing resources (n=12).

Stage 1: Factors included lack of patient information about symptoms and risk factors, prioritisation of other conditions and use of self-management. Healthcare professionals felt vertebral fractures were harder to identify in lower risk groups and mistook them for other conditions. Difficulties in communication between primary and secondary care meant that patients were not always informed of their diagnosis, or did not start treatment promptly.
Stage 2: 14 recommendations to improve management of vertebral fractures were identified, including for primary care healthcare professionals (n=9) and patients (n=5).
Stage 3: The need for allied health professionals in primary care to be informed about vertebral fractures was highlighted, along with ensuring that resources appealed to under-represented groups. Prototype resources were developed. Changes included help-seeking guidance and clear explanations of medical language.

The study used robust qualitative methods to co-produce knowledge sharing resources to improve diagnosis. A co-production approach enabled a focus on areas stakeholders thought to be beneficial to timely and accurate diagnosis and treatment. Dissemination of these resources to a range of stakeholders provides potential for substantial reach and spread.
Original languageEnglish
Article number165 (2024)
Number of pages19
JournalBMC Musculoskeletal Disorders
Issue number1
Publication statusPublished - 21 Feb 2024

Bibliographical note

Funding Information:
This project is funded by the NIHR Research for Patient Benefit programme, NIHR201523. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© The Author(s) 2024.


  • qualitative
  • osteoporosis
  • vertebral fractures
  • co-production


Dive into the research topics of 'Improving patients’ experiences of diagnosis and treatment of vertebral fracture: co-production of knowledge sharing resources'. Together they form a unique fingerprint.

Cite this