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Improving uptake of Fracture Prevention drug treatments: a protocol for Development of a consultation intervention (iFraP-D).

Paskins, Zoe; Bullock, Laurna; Crawford-Manning, Fay; Cottrell, Elizabeth; Fleming, Jane; Leyland, Sarah; Edwards, John James; Clark, Emma; Thomas, Simon; Chapman, Stephen Robert; Ryan, Sarah; Lefroy, Janet E; Gidlow, Christopher J; Iglesias, C; Protheroe, Joanne; Horne, Robert; O'Neill, Terence W; Mallen, Christian; Jinks, Clare

Improving uptake of Fracture Prevention drug treatments: a protocol for Development of a consultation intervention (iFraP-D). Thumbnail


Fay Crawford-Manning

Elizabeth Cottrell

Jane Fleming

Sarah Leyland

John James Edwards

Emma Clark

Simon Thomas

Stephen Robert Chapman

Sarah Ryan

Christopher J Gidlow

C Iglesias

Robert Horne

Terence W O'Neill

Christian Mallen


INTRODUCTION: Prevention of fragility fractures, a source of significant economic and personal burden, is hindered by poor uptake of fracture prevention medicines. Enhancing communication of scientific evidence and elicitation of patient medication-related beliefs has the potential to increase patient commitment to treatment. The Improving uptake of Fracture Prevention drug treatments (iFraP) programme aims to develop and evaluate a theoretically informed, complex intervention consisting of a computerised web-based decision support tool, training package and information resources, to facilitate informed decision-making about fracture prevention treatment, with a long-term aim of improving informed treatment adherence. This protocol focuses on the iFraP Development (iFraP-D) work. METHODS AND ANALYSIS: The approach to iFraP-D is informed by the Medical Research Council complex intervention development and evaluation framework and the three-step implementation of change model. The context for the study is UK fracture liaison services (FLS), which enact secondary fracture prevention. An evidence synthesis of clinical guidelines and Delphi exercise will be conducted to identify content for the intervention. Focus groups with patients, FLS clinicians and general practitioners and a usual care survey will facilitate understanding of current practice, and investigate barriers and facilitators to change. Design of the iFraP intervention will be informed by decision aid development standards and theories of implementation, behaviour change, acceptability and medicines adherence. The principles of co-design will underpin all elements of the study through a dedicated iFraP community of practice including key stakeholders and patient advisory groups. In-practice testing of the prototype intervention will inform revisions ready for further testing in a subsequent pilot and feasibility randomised trial. ETHICS AND DISSEMINATION: Ethical approval was obtained from North West-Greater Manchester West Research Ethics Committee (19/NW/0559). Dissemination and knowledge mobilisation will be facilitated through national bodies and networks, publications and presentations. TRIAL REGISTRATION NUMBER: researchregistry5041.

Journal Article Type Article
Acceptance Date Jul 29, 2021
Publication Date Aug 18, 2021
Journal BMJ Open
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 11
Issue 8
Keywords rheumatology; musculoskeletal disorders; qualitative research
Publisher URL


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