Quality of life and radiotherapy related insufficiency fractures
Research type
Research Study
Full title
Understanding the qualitative experience and impact on quality of life in patients with radiotherapy related insufficiency fractures
IRAS ID
308643
Contact name
Sally Taylor
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
0 years, 6 months, 2 days
Research summary
Research Summary
After receiving pelvic radiotherapy, some people may experience bone breaks or fractures, known as radiotherapy related insufficiency fractures (RRIFs). Approximately one in six patients experience RRIFs 3-18 months after radiotherapy. RRIFs cause significant anxiety, pain and immobility. There is little research exploring the impact of RRIFs and no questionnaire has been developed to measure quality of life (QOL) in this patient group.
There are two questionnaires currently available: Short Musculoskeletal Function Assessment (SMFA) and EuroQOL- 5 (EQ-5D) but these have not been developed specifically for patients with RRIFs therefore may not fully capture the experience of fractures or impact on QOL in these patients. We would like to understand how these patients have been impacted by RRIFs and determine if existing questionnaires meet their needs and cover their experiences.
Approximately 15-20 patients who have experienced RRIF will take part in a short interview. The interviews will explore patient experience of RRIF and how this has impacted on their QOL. Participants will also review existing questionnaires (SMFA and EQ5D) to see if they address their experiences in terms of their QOL, physical function and economic aspects. Participants will also be asked to consider if there are important areas not covered within these questionnaires. Key demographic information (age/ethnicity/diagnosis) will also be collected during the interview. Participants will be selected from a list of patients who have experienced RRIF held at The Christie NHS Foundation Trust.
Key themes will be identified from the interviews and summarised. The findings will be used to produce a written report of patient experience for publication. Findings will also be used to provide evidence for the development of a new questionnaire for RRIFs that will support future research and grant applications. The study is part of a student research project and does not have any specific funding assigned to it.
Summary of Results
Experiencing a radiotherapy related insufficiency fracture (RRIF), had a negative impact on the lives of participants. The majority of participants reported pain and described how the fracture had impacted on many elements of their lives such as daily activities, sleep, hobbies and leisure, social and family relationships, and employment. Some participants also described a negative impact on their emotional wellbeing. Many participants said they would value more information about RRIFs and would benefit from speaking to peers who have had similar experiences. Interventions for the management for RRIFs were minimal. Some patients mentioned a lack of support and after care and in many cases people had taken on their own management (taking their own pain medication; sourcing walking aids; accessing physiotherapy). Some patients mentioned their fractures were monitored with regular scans. Participants were generally satisfied with the topics included in the existing questionnaires but made some suggestions for improvement such as more focus on general radiotherapy side effects; less repetition in the questions; reducing the number of questions; more coverage of emotional issues; and making the response options less rigid. Patients felt a questionnaire would be a useful tool for clinical practice but should be completed closer towards the end of treatment and then at regular intervals. The interviews have provided important information about the experience of people with RRIF which we hope we will be able to use to improve service delivery and experiences for patients in the future.
REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
22/NW/0027
Date of REC Opinion
22 Jan 2022
REC opinion
Favourable Opinion