JAMDA
Volume 12, Issue 1 , Pages 50-57 , January 2011

Improving Adherence With the Use of Hip Protectors Among Older People Living in Nursing Care Facilities: A Cluster Randomized Trial

  • Ian D. Cameron, MB, BS, PhD

      Affiliations

    • Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Ryde NSW, Australia
    • Corresponding Author InformationAddress correspondence to Ian D. Cameron, Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, PO Box 6, Ryde NSW 1680, Australia.
    • ,
  • Susan E. Kurrle, MB, BS, PhD

      Affiliations

    • Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Hospital, Hornsby NSW, Australia
    • ,
  • Susan Quine, MSc, MPH, PhD

      Affiliations

    • Sydney School of Public Health, Building A27 University of Sydney, NSW, Australia
    • ,
  • Philip N. Sambrook, MD, BS, LLB

      Affiliations

    • Institute of Bone & Joint Research, Sydney Medical School, University of Sydney NSW, Australia
    • ,
  • Lyn March, MB, BS, MSc, PhD

      Affiliations

    • Institute of Bone & Joint Research, Sydney Medical School, University of Sydney NSW, Australia
    • ,
  • Daniel K.Y. Chan, MB, BS, MD

      Affiliations

    • Department of Aged Care & Rehabilitation, University of NSW, Bankstown Hospital, Bankstown, NSW, Australia
    • ,
  • Keri Lockwood, BHSc (Nursing)

      Affiliations

    • Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Hospital, Hornsby NSW, Australia
    • ,
  • Bronwyn Cook, BN

      Affiliations

    • Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Hospital, Hornsby NSW, Australia
    • ,
  • Frederieke F. Schaafsma, MD, PhD

      Affiliations

    • Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Ryde NSW, Australia

References 

  1. Wortberg WE. Huft-fraktur-bandage zur Verhinderung von Oberschenkelhalsbruch bei alteren Menschen [Hip-fracture-bandage to prevent hip fractures in elderly people.] Zeitschrift fur Gerontologie 1988;21:169–173.
  2. Bentzen H, Bergland A, Forsén L. Risk of hip fractures in soft protected, hard protected, and unprotected falls. Inj Prev. 2008;14:306–310
  3. Koike T, Orito Y, Toyoda H, et al. External hip protectors are effective for the elderly with higher-than-average risk factors for hip fractures. Osteoporos Int. 2009;20:1613–1620
  4. Kiel DP, Magaziner J, Zimmerman S, et al. Efficacy of a hip protector to prevent hip fracture in nursing home residents. The HIP PRO Randomized Controlled Trial. JAMA. 2007;298:413–422
  5. Parker MJ, Gillespie WJ, Gillespie LD. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev 2005;(3): CD001255. Available at: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001255/frame.html. Accessed March 3, 2010.
  6. Parker MJ, Gillespie WJ, Gillespie LD. Effectiveness of hip protectors for preventing hip fractures in elderly people: Systematic review. BMJ. 2006;11(332):571–574
  7. Van Schoor NM, Deville WL, Bouter LM, Lips P. Acceptance and compliance with external hip protectors: A systematic review of the literature. Osteoporos Int. 2002;13:917–924
  8. Kurrle SE, Cameron ID, Quine S. Predictors of adherence with the recommended use of hip protectors. J Gerontol A Biol Sci Med Sci. 2004;59:958–961
  9. Hubacher M, Wettstein A. Acceptance of hip protectors for hip fracture prevention in nursing homes. Osteoporos Int. 2001;12:794–799
  10. Cryer C, Knox A, Stevenson E. Factors associated with hip protector adherence among older people in residential care. Inj Prev. 2008;14:24–29
  11. Sawka AM, Nixon M, Giangregorio L, et al. The use of hip protectors in long-term care facilities: A survey of nursing home staff. J Am Med Dir Assoc. 2007;8:229–232
  12. Honkanen LA, Monaghan N, Reid MC, et al. Can hip protector use in the nursing home be predicted?. J Am Geriatr Soc. 2007;55:350–356
  13. Meyer G, Warnke A, Bender R, Muhlhauser I. Effect on hip fractures of increased use of hip protectors in nursing homes: Cluster randomised controlled trial. BMJ. 2003;326:76–80
  14. Cameron ID, Quine S. External hip protectors: Likely non-compliance among high risk elderly people living in the community. Arch Gerontol Geriatr. 1994;19:273–281
  15. Holtzman J, Lurie N. Causes of increasing mortality in a nursing home population. J Am Geriatr Soc. 1996;44:258–264
  16. Lord SR, March LM, Cameron ID, et al. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc. 2003;51:1645–1650
  17. Granger CV, Albrecht GL, Hamilton BB. Outcome of comprehensive medical rehabilitation: Measurement by PULSES Profile and the Barthel Index. Arch Phys Med Rehabil. 1979;60:145–154
  18. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23:433–441
  19. Euroquol The EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208
  20. Cameron ID, Robinovitch S, Birge S, et al. Hip protectors: Recommendations for conducting clinical trials—an international consensus statement (part II). Osteoporos Int. 2010;21:1–10
  21. Donner A, Klar N. Methods for comparing event rates in intervention studies when the unit of allocation is a cluster. Am J Epidemiol. 1994;140:279–289
  22. Donner A, Birkett N, Buck C. Randomization by cluster. Sample size requirements and analysis. Am J Epidemiol. 1981;114:906–914
  23. O'Halloran PD, Murray LJ, Cran GW, et al. The effect of type of hip protector and resident characteristics on adherence to use of hip protectors in nursing and residential homes—an exploratory study. Int J Nurs Stud. 2005;42:387–397
  24. Burl JB, Centola J, Bonner A, Burque C. Hip protector compliance: A 13-month study on factors and cost in a long-term care facility. J Am Med Dir Assoc. 2003;4:245–250

 Clinical trial registration: ACTRN012607000352404. The study was supported by an Australian National Health and Medical Research Council Grant (358372).

PII: S1525-8610(10)00067-8

doi: 10.1016/j.jamda.2010.02.010

JAMDA
Volume 12, Issue 1 , Pages 50-57 , January 2011

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