OBJECTIVE: To assess whether hip protectors used among women living in the community in the United Kingdom and at high risk of hip fracture, lead to a reduction in hip fracture. DESIGN: Pragmatic randomized controlled trial (RCT). SETTING: Primary care with participants being recruited largely from general practitioners' patient lists. PARTICIPANTS: Women aged 70 years and over with one or more risk factors for hip fracture (i.e., low body weight, current smoker, a prior fracture, family history of hip fracture). INTERVENTION: Three pairs of hip protectors of the "shell" type mailed to participants with instructions on how to use them. MAIN OUTCOME MEASURE: Reduction in hip fractures. RESULTS: 1,388 and 2,781 women aged 70 years or over were randomized to be given three pairs of hip protectors or act as controls, respectively. We followed up both groups of women for a minimum of 24 months (maximum 42 months, median 28). Compliance was poor with only 31% of participants reporting that they wore the hip protectors on a daily basis at 12 months. Intention-to-treat analysis showed that there was no statistically significant difference in the unadjusted odds ratios (ORs) of sustaining a hip fracture between the groups (OR = 1.19; 95% confidence interval, 0.80 to 1.78, p = 0.40). Adjustment for important covariates did not materially change these findings (OR = 1.17; 95% CI, 0.78 to 1.75). Comparing the rate of hip fracture between those women who regularly wore the devices and the control group yielded an OR of 1.12 (95% CI, 0.58 to 2.03; p = 0.83). CONCLUSION: This study is the largest RCT of hip protectors to date and provides no evidence of an effect of hip protectors among women living independently and at high risk of fracture.
RCT Entities:
OBJECTIVE: To assess whether hip protectors used among women living in the community in the United Kingdom and at high risk of hip fracture, lead to a reduction in hip fracture. DESIGN: Pragmatic randomized controlled trial (RCT). SETTING: Primary care with participants being recruited largely from general practitioners' patient lists. PARTICIPANTS: Women aged 70 years and over with one or more risk factors for hip fracture (i.e., low body weight, current smoker, a prior fracture, family history of hip fracture). INTERVENTION: Three pairs of hip protectors of the "shell" type mailed to participants with instructions on how to use them. MAIN OUTCOME MEASURE: Reduction in hip fractures. RESULTS: 1,388 and 2,781 women aged 70 years or over were randomized to be given three pairs of hip protectors or act as controls, respectively. We followed up both groups of women for a minimum of 24 months (maximum 42 months, median 28). Compliance was poor with only 31% of participants reporting that they wore the hip protectors on a daily basis at 12 months. Intention-to-treat analysis showed that there was no statistically significant difference in the unadjusted odds ratios (ORs) of sustaining a hip fracture between the groups (OR = 1.19; 95% confidence interval, 0.80 to 1.78, p = 0.40). Adjustment for important covariates did not materially change these findings (OR = 1.17; 95% CI, 0.78 to 1.75). Comparing the rate of hip fracture between those women who regularly wore the devices and the control group yielded an OR of 1.12 (95% CI, 0.58 to 2.03; p = 0.83). CONCLUSION: This study is the largest RCT of hip protectors to date and provides no evidence of an effect of hip protectors among women living independently and at high risk of fracture.
Authors: I D Cameron; J Venman; S E Kurrle; K Lockwood; C Birks; R G Cumming; S Quine; G Bashford Journal: Age Ageing Date: 2001-11 Impact factor: 10.668
Authors: I D Cameron; B Stafford; R G Cumming; C Birks; S E Kurrle; K Lockwood; S Quine; T Finnegan; G Salkeld Journal: Age Ageing Date: 2000-01 Impact factor: 10.668
Authors: Yvonne F Birks; Ruth Hildreth; Peter Campbell; Christine Sharpe; David J Torgerson; Ian Watt Journal: Age Ageing Date: 2003-07 Impact factor: 10.668
Authors: Anna M Sawka; Pauline Boulos; Karen Beattie; Lehana Thabane; Alexandra Papaioannou; Amiram Gafni; Ann Cranney; Nicole Zytaruk; David A Hanley; Jonathan D Adachi Journal: Osteoporos Int Date: 2005-07-01 Impact factor: 4.507
Authors: I D Cameron; S Kurrle; S Quine; P Sambrook; L March; D Chan; J Stocks; K Lockwood; B Cook; F G Schaafsma Journal: Osteoporos Int Date: 2010-06-23 Impact factor: 4.507
Authors: Jill Porthouse; Sarah Cockayne; Christine King; Lucy Saxon; Elizabeth Steele; Terry Aspray; Mike Baverstock; Yvonne Birks; Jo Dumville; Roger Francis; Cynthia Iglesias; Suezann Puffer; Anne Sutcliffe; Ian Watt; David J Torgerson Journal: BMJ Date: 2005-04-30
Authors: T Koike; Y Orito; H Toyoda; M Tada; R Sugama; M Hoshino; Y Nakao; S Kobayashi; K Kondo; Y Hirota; K Takaoka Journal: Osteoporos Int Date: 2009-01-10 Impact factor: 4.507