COPE v1.0
Research type
Research Study
Full title
Model of care development for non-operative proximal humerus fractures (COPE - Patient led earlier mobilisation for COnservatively managed displaced Proximal humErus fractures)
IRAS ID
349037
Contact name
David Wright
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
0 years, 4 months, 0 days
Research summary
Patients who have broken their shoulder within the last 18 months (identified by University Hospitals of Leicester physiotherapy department, fracture clinic and Accident and Emergency department) will be invited to participate in focus groups to discuss their views on removing their sling earlier after such an injury. The focus groups will be arranged and conducted by researchers from the University of Leicester. Focus groups will be audio-recorded and transcribed verbatim by an external transcription company with an established contract with the University of Leicester. The data will be analysed using thematic analysis by the lead researcher. Following this, the information gathered will be summarised, and an online consensus panel meeting held, inviting 2-3 participants from the patient focus groups, alongside health care professionals (focus groups have already been completed as part of a separate University Ethics only approved study) and they have agreed to be contacted) and members of the research team, to agree on what a model of care should look like if we removed slings earlier. Nominal group technique will be used to reach agreement, and data analysed using thematic analysis
Lay summary of study results: Breaking the top of the upper arm bone (a proximal humerus fracture) is common and is often treated by immobilising the arm in a sling. However, there is no clear agreement about how long people should wear the sling. Some research suggests that removing it earlier may help recovery, but little is known about how patients feel about doing this.
We invited 12 people who had recently suffered with a shoulder fracture to take part in group discussions. We asked about their experiences of wearing a sling and how they felt about removing it earlier. We analysed these discussions to understand the main factors that influenced their views.
Three key themes were identified. First, pain and fear were major barriers. Many people worried that moving their shoulder too soon would cause more damage, especially if they had received different advice from healthcare professionals. Second, the sling provided both physical support and emotional reassurance, making some people reluctant to stop using it. Finally, clear and timely information was very important. Participants felt more confident when they understood why early movement was safe, had exercises clearly demonstrated, and had their X-rays explained. They also preferred information that was personalised and available in different formats, such as written leaflets and videos.
These findings show that helping people remove their sling earlier involves more than simply changing the recommended timing. Patients need clear, consistent advice, good pain management, reassurance, and information that helps them understand why early movement is safe. These findings will be used alongside healthcare professionals' views to co-design a patient-centred model of care for future research and clinical practice.REC name
London - South East Research Ethics Committee
REC reference
25/PR/0973
Date of REC Opinion
1 Aug 2025
REC opinion
Further Information Favourable Opinion