Improving Shared DECISion-making in oldEr Hip Fracture Patients Living With Frailty
Starting soon
Conditions studied: Hip Fractures (i.e. Femoral Neck or Intertrochanteric Hip Fractures), Hip Fractures (ICD-10 72.01-72.2), Hip Fracture, Hip Fracture, Post Surgery Recovery, Muscle Resilience
In brief
Title Improving shared decision-making in older hip fracture patients living with frailty Aim To use routinely information normally collected by the NHS, and interviews with patients, families, and healthcare professionals, to produce an aid to help patients make decisions about hip fracture treatment that reflects what is important to them. Background Breaking a hip after a fall is common in older adults. The risk of dying is high after a hip fracture, especially if the person does not have surgery. Most UK patients have surgery even if they are very frail. Patients who are at a very high risk of dying still have surgery to help control the pain. However, this is not the same in all countries and recent studies show pain can be well controlled with medications and nerve-numbing drugs. Whilst the risk of dying is still much higher without surgery, to some frail older adults there are more important things to them than living longer like being able to walk and look after themselves. Some people may choose end-of-care instead of an operation if surgery means they won't be able to do these things afterwards. To help frail older people make the decision that is best for them, they need information about all treatment options and what their life is likely to be like after. This information needs to be easy to understand. Why the research is important This research will give frail older people with hip fractures the information they need to make decisions that focus on what is most important to them. We will make a guide to present the information in a way that is easy to understand and will help patients make decisions alongside healthcare professionals. Design We will complete 4 Work Packages (WPs): WP1: What do we already know about the link between frailty and the ability for older people to move and look after themselves after hip fracture? • We will review all current studies that look at what frail older peoples' lives are like after having a hip fracture and combine all the information in these studies. This will stop us from repeating work already done and show us any gaps in knowledge. WP2: Can we use how frail someone is and other information to predict their ability to move and look after themselves after a hip fracture? • We will use data the NHS collects to explore links between frailty, health and social issues, and a person's ability to move, walk, and care for themselves after hip fracture. I will see if these factors predict which people will do better after a hip fracture. WP3: What factors affect treatment decisions in frail adults with a hip fracture? • We will interview older hip fracture patient with frailty, families, and healthcare staff to explore how decisions are made about hip fractures and how we can improve this. WP4: Creating and testing an aid to help older patients with frailty make decisions about hip fracture treatment • We will work with patients to design a decision aid to improve shared decision-making in hip fracture care. We will test out the aid on orthopaedic wards in Southampton and improve it based on feedback.
Key facts
- Study ID
- NCT07687108
- Run by
- University of Southampton
- People needed
- 42
- Starts
- 2026-10-01
- Expected to finish
- 2029-02-07
- Last updated by the study team
- 2026-07-07
Who can join
Age: 65 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Aged ≥65
- Fragility fracture of the proximal femur defined as a fall from standing height or less from August 2021 to present
- Electronic frailty index (eFI) or eFI2 score in the 12 months preceding hip fracture for CPRD data; American Society of Anesthesiologists (ASA) Physical Status grade for NHFD data
You may not qualify if…
- Age <65
- Femoral shaft or distal femur fractures, periprosthetic fractures, and pathological fractures.
- PHASE 2 ELIGIBILITY CRITERIA
- Group 1 - Patients
- Inclusion criteria:
- Age ≥65
- Admitted to a trauma and orthopaedic ward at University Hospital Southampton following a fragility fracture of the hip
- Exclusion criteria:
- Distal femoral shaft fractures, periprosthetic fractures, pathological fractures
- Non-fragility fractures, defined as a fracture due to a force greater than falling from a standing height
- Group 2 - Families and carers
- Inclusion criteria:
- Age ≥18
- Carer or next of kin for a person meeting the eligibility criteria for group 1
- Exclusion criteria:
- Do not have the capacity to consent to participation in the study.
- Group 3 - Local healthcare professionals
- Inclusion criteria:
- Registered healthcare professionals involved in acute hip fracture management decisions including physicians, orthopaedic surgeons, anaesthetists, nurses and allied health professionals.
- Currently work or have worked within the past 6 months at University Hospital Southampton
- Group 4 - European healthcare professionals
- Inclusion criteria
- Registered healthcare professionals involved in acute hip fracture management decisions including physicians, orthopaedic surgeons, nurses and allied health professionals.
- Currently work or have worked within the past 6 months in trauma and orthopaedics or orthogeriatrics at a European hospital
- Eligibility criteria - Phase 3
Where it is running
- University Hospital Southampton NHS Foundation Trust — Southampton, Hampshire, United Kingdom
Full record on ClinicalTrials.gov
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