Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international survey
Aims: To identify factors influencing clinicians’ decisions to undertake a nonoperative hip fracture management approach among older people, and to determine whether there is global heterogeneity regarding these factors between clinicians from high-income countries (HIC) and low- and middle-income c...
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2023-10-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0069.R1 |
| _version_ | 1797648108505530368 |
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| author | Lucille Xiang Mriganka Singh Lynn McNicoll Iain K. Moppett |
| author_facet | Lucille Xiang Mriganka Singh Lynn McNicoll Iain K. Moppett |
| author_sort | Lucille Xiang |
| collection | DOAJ |
| description | Aims: To identify factors influencing clinicians’ decisions to undertake a nonoperative hip fracture management approach among older people, and to determine whether there is global heterogeneity regarding these factors between clinicians from high-income countries (HIC) and low- and middle-income countries (LMIC). Methods: A SurveyMonkey questionnaire was electronically distributed to clinicians around the world through the Fragility Fracture Network (FFN)’s Perioperative Special Interest Group and clinicians’ personal networks between 24 May and 25 July 2021. Analyses were performed using Excel and STATA v16.0. Between-group differences were determined using independent-samples t-tests and chi-squared tests. Results: A total of 406 respondents from 51 countries answered the questionnaire, of whom 225 came from HIC and 180 from LMIC. Clinicians from HIC reported a greater median and mean estimated proportion of admitted patients with hip fracture undergoing surgery (median 96% (interquartile range (IQR) 95% to 99%); mean 94% (SD 8%)) than those from LMIC (median 85% (IQR 75% to 95%); mean 81% (SD 16%); p < 0.001). Global heterogeneity seems to exist regarding factors such as anticipated life expectancy, insufficient resources, ability to pay, treatment costs, and perception of risk in hip fracture management decision-making. Conclusion: This study represents the first international sampling of clinician perspectives regarding nonoperative hip fracture management. Several factors seemed to influence the clinician decision-making process. Further research is needed to inform the development of best practice guidelines to improve decision-making and the quality of hip fracture care among older people. Cite this article: Bone Jt Open 2023;4(10):766–775. |
| first_indexed | 2024-03-11T15:26:26Z |
| format | Article |
| id | doaj.art-a72aba6c8070418f8c174948c176b7de |
| institution | Directory Open Access Journal |
| issn | 2633-1462 |
| language | English |
| last_indexed | 2024-03-11T15:26:26Z |
| publishDate | 2023-10-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj.art-a72aba6c8070418f8c174948c176b7de2023-10-27T13:27:29ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622023-10-0141076677510.1302/2633-1462.410.BJO-2023-0069.R1Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international surveyLucille Xiang0https://orcid.org/0000-0002-8456-3366Mriganka Singh1https://orcid.org/0000-0003-2479-600XLynn McNicoll2Iain K. Moppett3https://orcid.org/0000-0003-3750-6067School of Public Health, Brown University, Providence, Rhode Island, USADivision of Geriatrics, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USADivision of Geriatrics, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USAAnaesthesia and Critical Care, Injury, Recovery & Inflammation Sciences, The University of Nottingham, Queen’s Medical Centre, Nottingham, UKAims: To identify factors influencing clinicians’ decisions to undertake a nonoperative hip fracture management approach among older people, and to determine whether there is global heterogeneity regarding these factors between clinicians from high-income countries (HIC) and low- and middle-income countries (LMIC). Methods: A SurveyMonkey questionnaire was electronically distributed to clinicians around the world through the Fragility Fracture Network (FFN)’s Perioperative Special Interest Group and clinicians’ personal networks between 24 May and 25 July 2021. Analyses were performed using Excel and STATA v16.0. Between-group differences were determined using independent-samples t-tests and chi-squared tests. Results: A total of 406 respondents from 51 countries answered the questionnaire, of whom 225 came from HIC and 180 from LMIC. Clinicians from HIC reported a greater median and mean estimated proportion of admitted patients with hip fracture undergoing surgery (median 96% (interquartile range (IQR) 95% to 99%); mean 94% (SD 8%)) than those from LMIC (median 85% (IQR 75% to 95%); mean 81% (SD 16%); p < 0.001). Global heterogeneity seems to exist regarding factors such as anticipated life expectancy, insufficient resources, ability to pay, treatment costs, and perception of risk in hip fracture management decision-making. Conclusion: This study represents the first international sampling of clinician perspectives regarding nonoperative hip fracture management. Several factors seemed to influence the clinician decision-making process. Further research is needed to inform the development of best practice guidelines to improve decision-making and the quality of hip fracture care among older people. Cite this article: Bone Jt Open 2023;4(10):766–775.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0069.R1quality of lifehip fracture managementsurveynonoperativecovid-19clinician decision-makinghip fracturescliniciansnonoperative managementcovid-19 pandemict-testschi-squared testsfragility fracturemedical comorbiditiesanesthesiologistsfrailty |
| spellingShingle | Lucille Xiang Mriganka Singh Lynn McNicoll Iain K. Moppett Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international survey Bone & Joint Open quality of life hip fracture management survey nonoperative covid-19 clinician decision-making hip fractures clinicians nonoperative management covid-19 pandemic t-tests chi-squared tests fragility fracture medical comorbidities anesthesiologists frailty |
| title | Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international survey |
| title_full | Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international survey |
| title_fullStr | Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international survey |
| title_full_unstemmed | Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international survey |
| title_short | Clinician perspectives on nonoperative management of hip fractures during COVID-19: an international survey |
| title_sort | clinician perspectives on nonoperative management of hip fractures during covid 19 an international survey |
| topic | quality of life hip fracture management survey nonoperative covid-19 clinician decision-making hip fractures clinicians nonoperative management covid-19 pandemic t-tests chi-squared tests fragility fracture medical comorbidities anesthesiologists frailty |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.410.BJO-2023-0069.R1 |
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