Randomized controlled trial of hip protectors among women living in the community.
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.


METHODS
Pragmatic randomized controlled trial (RCT).


METHODS
Primary care with participants being recruited largely from general practitioners' patient lists.


METHODS
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).


METHODS
Three pairs of hip protectors of the "shell" type mailed to participants with instructions on how to use them.


METHODS
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).


CONCLUSIONS
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.
Birks
Yvonne F
YF
Primary Care Hip Protector Trial Group, York Trials Unit, Department of Health Sciences, York University, Area 4, Seebhom Rowntree Building, YO10 5DD, UK.
Porthouse
Jill
J
Addie
Caroline
C
Loughney
Karen
K
Saxon
Lucy
L
Baverstock
Mike
M
Francis
Roger M
RM
Reid
David M
DM
Watt
Ian
I
Torgerson
David J
DJ
D000058:Accidental Falls; D000368:Aged; D004867:Equipment Design; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D010024:Osteoporosis / Q000150:complications; D010349:Patient Compliance; D011320:Primary Health Care / Q000379:methods; D011482:Protective Devices; D012307:Risk Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology