title: Increasing adherence with the use of hip protectors for older people living in the community.
abstract: For people at high risk of hip fracture living in community settings, providing hip protectors at no cost increased adherence, but the additional effect of an educational programme was limited. Overall, the level of adherence was modest.
  
  
  BACKGROUND
  The objective of the study was to increase adherence with hip protector use by older people at high risk of hip fracture. The study included two randomised controlled trials with 308 older people recruited from three hospital rehabilitation wards and 171 older people recruited from the community.
  
  
  METHODS
  Participants were randomised into three groups. The control group received a brochure about hip protectors. The no cost group were fitted with free hip protectors and asked to use them. The combined group received free hip protectors and education sessions about their use. Adherence with the use of hip protectors at 3 and 6 months after recruitment was measured. Secondary outcomes were falls, fractures and hospitalisations.
  
  
  RESULTS
  Very few participants in the two control groups bought a hip protector. Overall adherence in the four intervention groups was modest, but higher in the community recruitment setting (49%) than in the hospital recruitment setting (36%) at 6 months. In the community recruitment group, at 3 months of follow-up, a significantly higher number of participants in the combined group (62%) were wearing hip protectors compared to the no cost group (43%, p=0.04). Five hip fractures occurred during the study, with four sustained whilst not wearing the hip protectors.
  
  
  CONCLUSIONS
  Providing hip protectors at no cost to community living older people at high risk of hip fractures modestly increases initial acceptance and adherence with hip protector use. Additional education may further increase hip protector use in people living in the community in the short term.
authors.affiliation: Sydney Medical School, University of Sydney, Sydney, Australia. ian.cameron@sydney.edu.au
authors.forename: I D
authors.initials: ID
authors.lastname: Cameron
authors.forename: S
authors.initials: S
authors.lastname: Kurrle
authors.forename: S
authors.initials: S
authors.lastname: Quine
authors.forename: P
authors.initials: P
authors.lastname: Sambrook
authors.forename: L
authors.initials: L
authors.lastname: March
authors.forename: D
authors.initials: D
authors.lastname: Chan
authors.forename: J
authors.initials: J
authors.lastname: Stocks
authors.forename: K
authors.initials: K
authors.lastname: Lockwood
authors.forename: B
authors.initials: B
authors.lastname: Cook
authors.forename: F G
authors.initials: FG
authors.lastname: Schaafsma
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000517:prevention & control*; D006760:Hospitalization; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011482:Protective Devices / Q000706:statistics & numerical data*; D016896:Treatment Outcome