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.
MeSH: Caregivers, Humans, Osteoporosis, therapy, Osteoporotic Fractures, prevention & control, Referral and Consultation, Secondary Prevention
Index: Consultation, Delphi survey, Fracture Liaison Services, Intervention development, Osteoporosis, iFraP