Abstract
BackgroundA validated questionnaire to assess medication management of hip fracture patients within and outside the hospital setting was lacking. The study aims were to describe the hip fracture patient pathway, and develop a valid and feasible questionnaire to assess clinicians’ experience with medication management of hip fracture patients in different care settings throughout the patient pathway.MethodsThis qualitative, descriptive methodological study used strategic and snowball sampling. The questionnaire was developed, and face and content validity explored through interviews with stakeholders. Phase I described the hip fracture patient pathway, and identified questionnaire dimensions in semi-structured interviews with management and clinicians (n = 37). The patient pathway was also discussed in six meetings (n = 70). Phase II refined a first draft of the questionnaire through cognitive interviews with future respondents (n = 23). The draft was modified after each interview. Post hoc, cognitive interview data were analysed using matrix analysis to condense problems and solutions into themes and subthemes. Phase III, converted the final version to a digital format, and tested its feasibility with a subset of the cognitive interview participants (n = 21) who completed the questionnaire and provided feedback.ResultsPhase I: Hip fracture patients were cared for in at least three different care settings, and went through at least four handovers between and within primary and secondary care. Three questionnaire dimensions were identified: 1) Medication reconciliation and review, 2) Communication of key information, and 3) Profession and setting. Phase II: The MedHipPro-Q was representative of how the different professions experienced medication management in all settings, and hence showed face and content validity. Post hoc analysis: Problem themes (with sub-themes) were Representativeness (-of patient pathway and -of respondent reality) and Presentation (Language and Appearance). Solution themes (with sub-themes) were: Content (added or deleted) and Presentation (modified appearance or corrected language). Phase III: Participants did not identify technical, linguistic or content flaws in the questionnaire, and the digital version was considered feasible for use.ConclusionThe novel MedHipPro-Q showed good face and content validity, and was feasible for use throughout the hip fracture patient pathway. The rigorous development process supports its construct validity and reliability.
Highlights
A validated questionnaire to assess medication management of hip fracture patients within and outside the hospital setting was lacking
The existing studies on transfer of hip fracture patients between primary and secondary care [12, 13] do not focus on medication management
Phase I: Patient pathway and questionnaire dimensions Based on the established in-hospital fast track, and findings from the interviews, we described the hip fracture patient pathway with an emphasis on medication management (Fig. 2)
Summary
A validated questionnaire to assess medication management of hip fracture patients within and outside the hospital setting was lacking. Hip fracture patients are characterised by a high mean age [3], they suffer from comorbidities [4, 5], and polypharmacy is common [6]. Care transitions increases the risk of discrepancies in medication lists [7] Such discrepancies constitutes a potential risk to patient safety as it may lead to adverse events, such as inadequate treatment or (re)hospitalisation, and, in the most extreme cases, permanent harm [8]. The existing studies on transfer of hip fracture patients between primary and secondary care [12, 13] do not focus on medication management (i.e. prescribing of medication, its administration, reconciliation, review)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
