Optimising stakeholder engagement for informing direction and scope of a programme of Cochrane Reviews on hip fracture management




Poster session 3


Tuesday 18 September 2018 - 12:30 to 14:00

All authors in correct order:

Sreekanta A1, Felix L1, Grant R2, Handoll H3, Elliott J3, Cook JA1, Griffin XL1
1 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
2 Patient and Public Involvement Advisor, UK
3 Cochrane Bone, Joint and Muscle Trauma Group, University of Manchester, UK
Presenting author and contact person

Presenting author:

Ashwini Sreekanta

Contact person:

Abstract text
Effective stakeholder involvement at the planning stage of research proposals can add real value to the subsequent investigation. The best format for achieving this will vary according to the research area and context, and may include previous initiatives. We describe our approach to achieving this for an NIHR funded programme of Cochrane Reviews on hip fracture management, which aims to inform the current management of these patients and develop future practice guidelines.

We invited stakeholders from range of disciplines (orthopaedic surgery, anaesthesia, psychiatry, emergency medicine, physiotherapy, health policy, public and patient involvement (PPI), and methodology) directly involved, or with a strong interest, in the management of fragility hip fractures to a one-day workshop held in Oxford, UK. Preparatory material, including a scoping document and summaries of relevant published Cochrane Reviews, was circulated to stakeholders one week before the workshop. The three facilitators developed a script for guiding discussion in two discussion sessions focusing on review participants and subgroups, interventions (often complex), outcomes and prioritisation of reviews.

There were three discipline-balanced groups of seven participants. We recorded all discussions and summarised the points raised in a structured table. Key insights revolved round the hip fracture ‘care pathway’, with a proposal for one or more overviews that focused on perioperative care and rehabilitation. Other key insights for incorporating into ‘commissioning briefs’ for individual reviews concerned defining the main target population and better documentation. Consideration of co-interventions, such as early mobilisation, in trials that distinguish current practice, were highlighted. The insights and directions from the meeting acted as a basis for discussions, including the practicalities of delivery, with the Group’s editorial base members.

A targeted consultation workshop engaging stakeholders with first-hand practical experience at the initial stage explored a range of issues and the added insight gained helped to guide our decision-making in terms of the overall scope of the programme, and scopes of individual reviews.

Patient or healthcare consumer involvement:
The PPI participant gave particular feedback based on his direct experience as a carer of an elderly relative with hip fracture.


Relevance to patients and consumers: 

Our PPI representative participated in a James Lind Alliance Priority Setting exercise for lower limb injury, where it was highlighted that fragility hip fracture is a major priority amongst patients. As well as having direct experience as a carer, he gave specific guidance on selection of priority areas for reviews, and patient-centred outcomes. He also contributed to revision of the draft manuscript. Another workshop participant, The National Osteoporosis Society, is the leading advocacy organisation in this clinical area and will be involved in our dissemination products for lay audiences.