. 2021 Mar 24;16(1):58.

doi: 10.1007/s11657-021-00913-w.

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 Bullock¹, Fay Crawford-Manning^{2

3}, Elizabeth Cottrell², Jane Fleming⁴, Sarah Leyland⁵, John Edwards², Emma M Clark⁶, Simon Thomas⁷, Stephen Chapman⁷, Christopher Gidlow⁸, Cynthia P Iglesias^{9

10}, Joanne Protheroe², Robert Horne¹¹, Terence W O'Neill¹², Christian Mallen², Clare Jinks², Zoe Paskins^{2

3}

Affiliations

¹ School of Medicine, Keele University, Newcastle, Staffordshire, UK. l.bullock@keele.ac.uk.
² School of Medicine, Keele University, Newcastle, Staffordshire, UK.
³ Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, Staffordshire, UK.
⁴ Cambridge Public Health, University of Cambridge & Addenbrooke's Hospital Fracture Liaison Service, Cambridge University Hospitals NHS Trust, Cambridge, UK.
⁵ Royal Osteoporosis Society, Bath, UK.
⁶ Bristol Medical School, Faculty of Health Sciences,, University of Bristol, Bristol, UK.
⁷ School of Pharmacy and Bioengineering, Keele University, Newcastle, Staffordshire, UK.
⁸ Centre for Health and Development, Staffordshire University, Stoke-on-Trent, Staffordshire, UK.
⁹ Department of Health Sciences, University of York, York, UK.
¹⁰ Danish Centre for Healthcare Improvement (CHI), Aalborg University, Aalborg, Denmark.
¹¹ Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, London, UK.
¹² Centre for Epidemiology Versus Arthritis, University of Manchester & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK.

PMID: 33761007
PMCID: PMC7989712
DOI: 10.1007/s11657-021-00913-w

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 et al. Arch Osteoporos. 2021.

. 2021 Mar 24;16(1):58.

doi: 10.1007/s11657-021-00913-w.

Authors

Affiliations

¹ School of Medicine, Keele University, Newcastle, Staffordshire, UK. l.bullock@keele.ac.uk.
² School of Medicine, Keele University, Newcastle, Staffordshire, UK.
³ Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, Staffordshire, UK.
⁴ Cambridge Public Health, University of Cambridge & Addenbrooke's Hospital Fracture Liaison Service, Cambridge University Hospitals NHS Trust, Cambridge, UK.
⁵ Royal Osteoporosis Society, Bath, UK.
⁶ Bristol Medical School, Faculty of Health Sciences,, University of Bristol, Bristol, UK.
⁷ School of Pharmacy and Bioengineering, Keele University, Newcastle, Staffordshire, UK.
⁸ Centre for Health and Development, Staffordshire University, Stoke-on-Trent, Staffordshire, UK.
⁹ Department of Health Sciences, University of York, York, UK.
¹⁰ Danish Centre for Healthcare Improvement (CHI), Aalborg University, Aalborg, Denmark.
¹¹ Centre for Behavioural Medicine, UCL School of Pharmacy, University College London, London, UK.
¹² Centre for Epidemiology Versus Arthritis, University of Manchester & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK.

PMID: 33761007
PMCID: PMC7989712
DOI: 10.1007/s11657-021-00913-w

Abstract

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: Consultation; Delphi survey; Fracture Liaison Services; Intervention development; Osteoporosis; iFraP.

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Conflict of interest statement

None.

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References

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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

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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

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Conflict of interest statement

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