TY - JOUR
T1 - Shared decision-making for nonoperative management versus operative management of hip fractures in selected frail older adults with a limited life expectancy
T2 - a protocol for a nationwide implementation study
AU - Zeelenberg, Miliaan L.
AU - Oosterwijk, Paulieke C.
AU - Willems, Hanna C.
AU - Gosens, Taco
AU - Hartog, Dennis Den
AU - Joosse, Pieter
AU - Loggers, Sverre A.I.
AU - Nijdam, Thomas M.P.
AU - Pel-Littel, Ruth E.
AU - Polinder, Suzanne
AU - Schuijt, Henk Jan
AU - Wijnen, Hugo H.
AU - Van der Velde, Detlef
AU - Van Lieshout, Esther M.M.
AU - Verhofstad, Michael H.J.
AU - Sohl, E.
AU - Jansen, J. A.
AU - Leijnen, M.
AU - Van der Stappen, W. A.H.
AU - Jansen, J. A.
AU - Peters-Kop, M.
AU - Van der Veen, A. H.
AU - Schepel, N. C.
AU - Wilmer, J. A.M.
AU - Steens, J.
AU - Winkelhagen, J.
AU - Noorda, N. M.F.
AU - Maas, H. A.A.M.
AU - Wijers, O.
AU - Vis, V.
AU - Van der Stap, D.
AU - Roukema, G. R.
AU - Bosma, E.
AU - Van Raaij, T. M.
AU - Van der Knaap, A. M.
AU - De Groot, R.
AU - Zeegers, A. V.C.M.
AU - Formijne Jonkers, H. A.
AU - Kempen, D. H.R.
AU - De Vries, K.
AU - Pull ter Gunne, A. F.
AU - Somford, M. P.
AU - Tanis, E.
AU - Duits, J. H.
AU - Zandbergen, R. A.
AU - Leegwater, N. C.
AU - Geraghty, O. C.
AU - NOM-Implementation study group
AU - Hegeman, J. H.
AU - Regtuijt, E. M.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024.
PY - 2024/4/17
Y1 - 2024/4/17
N2 - Background and purpose Recent research has highlighted non-operative management (NOM) as a viable alternative for frail older adults with hip fractures in the final phase of life. This study aims to guide Dutch physicians and hospitals nationwide in a standardised implementation of shared decision-making regarding surgery or NOM in selected frail older adults with a hip fracture. Methods and analysis The patient population for implementation includes frail older adults aged ≥70 years with an acute proximal femoral fracture, nursing home care or a similar level of care elsewhere and at least one additional criterion (ie, malnutrition, severe mobility impairment or ASA≥4). The 2-year implementation study will be conducted in four phases. In phases 1 and 2, barriers and facilitators for implementation will be identified and an implementation protocol, educational materials and patient information will be developed. Phase 3 will involve an implementation pilot in 14 hospitals across the Netherlands. The protocol and educational material will be improved based on healthcare provider and patient experiences gathered through interviews. Phase 4 will focus on upscaling to nationwide implementation and the effect of the implementation on NOM rate will be measured using data from the Dutch Hip Fracture Audit. Ethics and dissemination The study was exempted by the local Medical Research Ethics Committee (MEC-2023-0270, 10 May 2023) and Medical Ethics Committee United (W23.083, 26 April 2023). The study’s results will be submitted to an open access international peer-reviewed journal. Its protocols, tools and results will be presented at several national and international academic conferences of relevant orthogeriatric (scientific) associations.
AB - Background and purpose Recent research has highlighted non-operative management (NOM) as a viable alternative for frail older adults with hip fractures in the final phase of life. This study aims to guide Dutch physicians and hospitals nationwide in a standardised implementation of shared decision-making regarding surgery or NOM in selected frail older adults with a hip fracture. Methods and analysis The patient population for implementation includes frail older adults aged ≥70 years with an acute proximal femoral fracture, nursing home care or a similar level of care elsewhere and at least one additional criterion (ie, malnutrition, severe mobility impairment or ASA≥4). The 2-year implementation study will be conducted in four phases. In phases 1 and 2, barriers and facilitators for implementation will be identified and an implementation protocol, educational materials and patient information will be developed. Phase 3 will involve an implementation pilot in 14 hospitals across the Netherlands. The protocol and educational material will be improved based on healthcare provider and patient experiences gathered through interviews. Phase 4 will focus on upscaling to nationwide implementation and the effect of the implementation on NOM rate will be measured using data from the Dutch Hip Fracture Audit. Ethics and dissemination The study was exempted by the local Medical Research Ethics Committee (MEC-2023-0270, 10 May 2023) and Medical Ethics Committee United (W23.083, 26 April 2023). The study’s results will be submitted to an open access international peer-reviewed journal. Its protocols, tools and results will be presented at several national and international academic conferences of relevant orthogeriatric (scientific) associations.
UR - http://www.scopus.com/inward/record.url?scp=85190869839&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2023-083429
DO - 10.1136/bmjopen-2023-083429
M3 - Article
C2 - 38631829
AN - SCOPUS:85190869839
SN - 2044-6055
VL - 14
SP - 1
EP - 8
JO - BMJ open
JF - BMJ open
IS - 4
M1 - e083429
ER -
