ArticleBMJ open2024
Patient and proxy perspectives in decision-making for geriatric hip fracture management in the Netherlands: a qualitative study.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Observational
- When 'No Surgery' Is Chosen: A Five-Domain Framework for Evaluating Ethical Consent in Non-Operative Hip Fracture Care.Journal of evaluation in clinical practice · 2026Article
- Attitudes of anesthesiologists towards implementation of PENG block in non-operative treatment of hip fractures in the Netherlands: a national survey study.BMC anesthesiology · 2026Article
- Factors influencing the implementation of best clinical practices for hip fracture management in resource-constrained hospitals in China and co-design of quality improvement interventions: a qualitative study.The Lancet regional health. Western Pacific · 2026Article
- Machine learning-based prediction of short- and long-term mortality for shared decision-making in older hip fracture patients: the Dutch Hip Fracture Audit algorithms in 74,396 cases.Acta orthopaedica · 2025Article
- Experience with hip denervation in non-operative hip fracture care for frail older patients in the Netherlands: an interview study.BMJ open · 2025Article
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Authors and funding
7 authors.
Funding
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Abstract
objectiveThe objective of this study was to explore the perspectives with the decision-making process between surgery and palliative, non-operative management of geriatric hip fracture patients and their proxies.
designSETTING AND
participantsHip fracture patients in the Netherlands were eligible for inclusion. For hip fracture patients with a pre-existing diagnosis of dementia and for patients who opted for palliative, non-operative management, proxies were included.
resultsA total of 16 interviews were conducted, consisting of 4 patient interviews and 12 proxy interviews. Five themes were identified during thematic analysis: (1) underlying patient values, (2) the provision of information, (3) reasons to consider either palliative, non-operative management or surgery, (4) involvement in decision and (5) realisation of expectations. Information provided by the physician varied in terms of desired level of detail but involved discussing the advantages and disadvantages of surgery and palliative, non-operative management. Patients and proxies underscored the importance of achieving optimal quality of life, and the disparity between expected and actual treatment outcomes was unpleasant and negatively influenced the overall experience.
conclusionsIn-depth analysis provided a unique insight into the patient and proxy perspectives in shared decision-making for geriatric hip fracture management in the acute setting. Overall, there were differences between reported experiences and preferences of participants. This heterogeneity stresses the importance of keeping a person-centred approach during shared decision-making. Other key considerations during shared decision-making include physicians informing patients from professional experience and communicating sensitively about both treatment options and prognosis. Physicians should aim to provide realistic, sensitive and timely information to both patients and proxies during the choice between curation and palliation for their hip fracture.
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