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J Am Med Dir Assoc. 2011 Jan;12(1):50-7. doi: 10.1016/j.jamda.2010.02.010. Epub 2010 Aug 12.

Improving adherence with the use of hip protectors among older people living in nursing care facilities: a cluster randomized trial.

Author information

  • 1Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Ryde NSW, Australia. ianc@mail.usyd.edu.au

Abstract

OBJECTIVES:

To test different adherent strategies aimed at improving hip protector use among nursing care facility residents.

DESIGN, SETTING AND PARTICIPANTS:

A cluster randomized controlled trial with 234 residents older than 75 years from 9 units of 7 nursing care facilities in the Northern Sydney region, Australia.

INTERVENTION:

Residents were cluster randomized in 3 groups. The first group received hard shell hip protectors without cost (no cost group). The second group received an educational session, a demonstration of the use of hip protectors, and free choice of type of hip protectors without cost (combined group). The third group was the control group who received a brochure about hip protectors.

MEASUREMENTS:

Primary outcome was adherence with the use of hip protectors at 3 and 6 months after recruitment. Secondary outcomes were falls, injuries, and fractures.

RESULTS:

No participants in the control group purchased hip protectors at any stage. At 3 months, 33% of participants in the no cost group and 27% in the combined group wore a hip protector at the time of visit. This declined to 25% and 24% respectively at 6 months. No significant difference was seen in any of the 3 adherence outcomes between the 2 intervention groups. The number of falls or hospitalizations did not differ between groups, with 5 hip fractures reported during the intervention period. Residents were more likely to be adherent if they were female and had greater restriction in daily activities.

CONCLUSION:

Providing free hip protectors to older people living in nursing care facilities was necessary to increase initial acceptance and adherence. Nevertheless, after 6 months the achieved level of adherence was not high enough to be associated with a reduction of hip fractures. The provision of educational sessions and demonstrations to nursing staff and participants had no added value in this trial.

PMID:
21194660
DOI:
10.1016/j.jamda.2010.02.010
[PubMed - indexed for MEDLINE]
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