Integrating post-fracture care into the primary care setting (interFRACT): Protocol for a mixed-methods study to co-design a care program to improve rates of osteoporosis and fracture treatment

Abstract

IntroductionDespite evidence showing that timely diagnosis and appropriate pharmacological treatment of osteoporosis reduces subsequent fracture rates, osteoporosis remains significantly underdiagnosed and undertreated. The large and ongoing treatment gap for osteoporosis and associated fragility fractures could be addressed by considering systematic approaches for post-fracture care in the primary care setting. This study will develop the Integrating Post-Fracture Care into Primary Care (interFRACT) care program that aims to enhance diagnosis and treatment of osteoporosis and improve initiation and adherence to fracture prevention strategies for older adults in the primary care setting.Methods and analysisThis mixed-methods study will follow an established co-design approach that involves six steps; the first three aim to gain an understanding of the consumer experience and needs, while the latter three focus on how to improve that experience through design and action. This will include: development of a Stakeholder Advisory Committee to provide guidance on all aspects of study design, including implementation, evaluation and dissemination; interviews with primary care physicians to explore beliefs and attitudes towards osteoporosis and fracture treatment; interviews with consumers (older adults with a diagnosis of osteoporosis and/or fragility fracture) to identify current needs for osteoporosis treatment and fracture prevention; a series of co-design workshops to develop the components of the interFRACT care program based on published guidance and findings from interviews; and a feasibility study with primary care physicians to determine the usability and acceptability of the interFRACT care program.Ethics and disseminationEthical approval was obtained from Deakin University Human Research Ethics Committee (approval number: HEAG-H 56_2022). Study results will be published in peer-reviewed journals, presented at national and international conferences, and collated in reports for participating primary care practices.

Rehabilitation nursing after lower limb fracture: Preventing deep vein thrombosis and enhancing quality of life

“…The study group implemented evidence-based nursing interventions during the perioperative period with specific methods, including establishing nursing teams and implementing standardized nursing training. [4,12,13] Specialized training on standardized nursing was provided to the grassroots nursing staff of each nursing team, focusing on explaining the specific reasons for LDVT. Psychological factors: Various negative emotions such as anxiety, tension, and fear that patients experience preoperatively can cause increased blood viscosity in the circulatory system, causing increased blood clot formation.…”

“…Ethical approval for this study was obtained from Liyuan Hospital of Tongji Medical College, Huazhong University of Science and Technology ethics committee. [4,12,13] Specialized training on standardized nursing was provided to the grassroots nursing staff of each nursing team, focusing on explaining the specific reasons for LDVT. Psychological factors:…”