Evidence map›Paper›PMID 35930725›Full record

ArticleAge and ageing2022

Shared decision-making for the treatment of proximal femoral fractures in frail institutionalised older patients: healthcare providers' perceived barriers and facilitators.

Inge Spronk, Sverre A I Loggers, Pieter Joosse, Hanna C Willems, Romke Van Balen, Taco Gosens, Kornelis J Ponsen, Jeroen Steens, C L P (Marc) Van de Ree, Rutger G Zuurmond and 3 more

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In one paragraph

Article in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Inge SpronkErasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.ORCID 0000-0001-9571-576X
Sverre A I LoggersDepartment of Surgery, Northwest Clinics Alkmaar, P.O Box 501, 1800 AM Alkmaar, The Netherlands.ORCID 0000-0003-3891-7124
Pieter JoosseDepartment of Surgery, Northwest Clinics Alkmaar, P.O Box 501, 1800 AM Alkmaar, The Netherlands.
Hanna C WillemsGeriatrics Section, Department of Internal Medicine, Amsterdam UMC location AMC, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Romke Van BalenDepartment of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands.
Taco GosensDepartment of Orthopaedic Surgery, Elisabeth-TweeSteden Ziekenhuis, PO Box 90151, 5000 LC Tilburg, The Netherlands.
Kornelis J PonsenDepartment of Surgery, Northwest Clinics Alkmaar, P.O Box 501, 1800 AM Alkmaar, The Netherlands.
Jeroen SteensDepartment of Orthopaedic Surgery, Dijklander Ziekenhuis, PO Box 600, 1620 AR Hoorn, The Netherlands.
C L P (Marc) Van de ReeDepartment Trauma TopCare, Elisabeth-TweeSteden Ziekenhuis, PO Box 90151, 5000 LC Tilburg, The Netherlands.
Rutger G ZuurmondDepartment of Orthopaedic Surgery, Isala, PO Box 10400, 8000 GK Zwolle, The Netherlands.
Michael H J VerhofstadTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Esther M M Van LieshoutTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Suzanne PolinderErasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionProximal femoral fractures are common in frail institutionalised older patients. No convincing evidence exists regarding the optimal treatment strategy for those with a limited pre-fracture life expectancy, underpinning the importance of shared decision-making (SDM). This study investigated healthcare providers' barriers to and facilitators of the implementation of SDM.

methodsDutch healthcare providers completed an adapted version of the Measurement Instrument for Determinants of Innovations questionnaire to identify barriers and facilitators. If ≥20% of participants responded with 'totally disagree/disagree', items were considered barriers and, if ≥80% responded with 'agree/totally agree', items were considered facilitators.

resultsA total of 271 healthcare providers participated. Five barriers and 23 facilitators were identified. Barriers included the time required to both prepare for and hold SDM conversations, in addition to the reflective period required to allow patients/relatives to make their final decision, and the number of parties required to ensure optimal SDM. Facilitators were related to patients' values, wishes and satisfaction, the importance of SDM for patients/relatives and the fact that SDM is not considered complex by healthcare providers, is considered to be part of routine care and is believed to be associated with positive patient outcomes.

conclusionAwareness of identified facilitators and barriers is an important step in expanding the use of SDM. Implementation strategies should be aimed at managing time constraints. High-quality evidence on outcomes of non-operative and operative management can enhance implementation of SDM to address current concerns around the outcomes.

Indexed as

Femoral FracturesFrail ElderlyAgedDecision MakingDecision Making, SharedHealth PersonnelHumansPatient Participationbarriersfacilitatorship fracturenon-operativeolder peopleshared decision-making

Identifiers

PMID35930725
PMCPMC9355456

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.