{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:16:22Z","timestamp":1791335782092,"version":"4.3.1"},"reference-count":26,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["10390162210008"],"award-info":[{"award-number":["10390162210008"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,3,12]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"\n Background and purpose<\/jats:title>\n Recent research has highlighted non-operative management (NOM) as a viable alternative for frail older adults with hip fractures in the final phase of life. This study aims to guide Dutch physicians and hospitals nationwide in a standardised implementation of shared decision-making regarding surgery or NOM in selected frail older adults with a hip fracture.<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n The patient population for implementation includes frail older adults aged \u226570 years with an acute proximal femoral fracture, nursing home care or a similar level of care elsewhere and at least one additional criterion (ie, malnutrition, severe mobility impairment or ASA\u22654). The 2-year implementation study will be conducted in four phases. In phases 1 and 2, barriers and facilitators for implementation will be identified and an implementation protocol, educational materials and patient information will be developed. Phase 3 will involve an implementation pilot in 14 hospitals across the Netherlands. The protocol and educational material will be improved based on healthcare provider and patient experiences gathered through interviews. Phase 4 will focus on upscaling to nationwide implementation and the effect of the implementation on NOM rate will be measured using data from the Dutch Hip Fracture Audit.<\/jats:p>\n <\/jats:sec>\n \n Ethics and dissemination<\/jats:title>\n The study was exempted by the local Medical Research Ethics Committee (MEC-2023-0270, 10 May 2023) and Medical Ethics Committee United (W23.083, 26 April 2023). The study\u2019s results will be submitted to an open access international peer-reviewed journal. Its protocols, tools and results will be presented at several national and international academic conferences of relevant orthogeriatric (scientific) associations.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT06079905<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-083429","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:13:00Z","timestamp":1714522380000},"page":"e083429","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Shared decision-making for non-operative management versus operative management of hip fractures in selected frail older adults with a limited life expectancy: a protocol for a nationwide implementation study"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct06079905","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06079905","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Miliaan L","family":"Zeelenberg","sequence":"first","affiliation":[{"name":"Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulieke C","family":"Oosterwijk","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Sint Antonius Ziekenhuis, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna C","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Amsterdam University Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taco","family":"Gosens","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Den Hartog","sequence":"additional","affiliation":[{"name":"Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Joosse","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sverre A I","family":"Loggers","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas MP","family":"Nijdam","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth E","family":"Pel-Littel","sequence":"additional","affiliation":[{"name":"Vilans, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Polinder","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7399-6828","authenticated-orcid":false,"given":"Henk Jan","family":"Schuijt","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Sint Antonius Hospital, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo H","family":"Wijnen","sequence":"additional","affiliation":[{"name":"Department of Clinical Geriatrics, Rijnstate, Arnhem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Detlef","family":"Van der Velde","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sint Antonius Ziekenhuis, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2597-7948","authenticated-orcid":false,"given":"Esther M M","family":"Van Lieshout","sequence":"additional","affiliation":[{"name":"Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H J","family":"Verhofstad","sequence":"additional","affiliation":[{"name":"Trauma Research Unit Department of Surgery, Erasmus MC, 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