Effectiveness and acceptability of a newly designed hip protector: a pilot study

Chan, Daniel Kam Yin; Hillier, Gary; Coore, Michelle; Cooke, R. T.; Monk, Rebecca; Mills, Janette; Hung, Wai Tak

doi:10.1016/s0167-4943(99)00048-5

Cited by 65 publications

(54 citation statements)

References 10 publications

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“…Finally, we have used this approach to highlight the effectiveness of hip protectors in decreasing the risk of hip fractures in a vulnerable, often ignored population with a significant burden of disease. Process of exclusion of studies from the systematic review [26][27][28][29][30][31][32][33][34][35][36]. Table 1 Assessment of the methodologic features of included studies The unit of randomization was not clearly described in the primary publication.…”

Section: Discussionmentioning

confidence: 99%

Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis

Sawka

Boulos

Beattie

et al. 2007

Journal of Clinical Epidemiology

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Objective-To design a Bayesian random effects model for pooling binary outcome data from cluster randomized trials (CRTs) with individually randomized trials (IRTs) and then use this model to determine if hip protectors decrease the risk of hip fracture in elderly nursing home residents.Study Design and Setting-Eight electronic databases were searched; abstracts and papers were reviewed in duplicate. Randomized controlled trials of hip protectors in nursing homes were included. The pooled mean odds ratio (OR) of a hip fracture in an individual allocated to hip protectors with 95% credibility interval (CRI) was calculated. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptResults-We included four trials of 1,922 individuals (including three CRTs). The pooled OR of an elderly nursing home resident sustaining one or more hip fractures with hip protector allocation was 0.40 (95% CRI 0.25, 0.61). The model was robust in multiple sensitivity analyses assuming alternative intracluster correlation coefficient values. Conclusion-TheBayesian approach may be used in meta-analyses of IRTs and CRTs. Using this approach, we have determined that hip protectors decrease the risk of hip fracture in elderly nursing home residents. Methodologic limitations of the included trials and a possible herd effect in CRTs may have influenced these results.

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Section: Discussionmentioning

confidence: 99%

Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis

Sawka

Boulos

Beattie

et al. 2007

Journal of Clinical Epidemiology

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“…It is difficult to compare the compliance in this study with the compliance in the other studies because purchasers are a very selected population. In the other studies, a prospective design was used [3,[17][18][19][20][21][22][23][24]. Table 2 shows the acceptance and compliance and the determinants of compliance with wearing hip protectors in these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Compliance varied between 20% and 92% [3,11,[16][17][18][19][20][21][22][23][24][25][26][27]29,30,32,47]. The median acceptance and compliance were 68% (interquartile range 57-70%) and 56% (interquartile range 41-73%), respectively.…”

Section: Discussionmentioning

confidence: 99%

Acceptance and Compliance with External Hip Protectors: A Systematic Review of the Literature

Schoor

Devillé

Bouter

et al. 2002

Osteoporosis International

130

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Abstract. Hip fractures may be prevented by the use of external hip protectors, but compliance is often poor. Therefore, the objective of this study was to assess the determinants of compliance with hip protectors by systematically reviewing the literature. A literature search was performed in PubMed, Embase and the Cochrane Library. Primary acceptance with hip protectors ranged from 37% to 72% (median 68%); compliance varied between 20% and 92% (median 56%). However, in most studies it was not very clear how compliance was defined (e.g., average wearing time on active days and during waking hours, number of user-days per all available follow-up days, percentage falls with hip protector) and how it was measured. To provide more insight in the compliance percentages, the different methods of defining and measuring compliance were presented for the selected studies, when provided. Because of the heterogeneity in study design of the selected studies and the lack of quantitative data in most studies, results regarding the determinants of compliance could not be statistically pooled. Instead a qualitative summary of the determinants of compliance was given. The reasons most frequently mentioned for not wearing hip protectors, were: not being comfortable (too tight/ poor fit); the extra effort (and time) needed to wear the device; urinary incontinence; and physical difficulties/ illnesses. In conclusion, compliance is a very complex, but important issue in hip protector research and implementation. Based on the experiences of elderly people who wear the hip protectors, adjustments should be made to the protector and the underwear, while maintaining the force attenuation capacity. Furthermore, methods to improve the compliance should be developed, and their effectiveness tested.

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“…These compliance results are comparable with the compliance results from other studies. In five out of eight randomized controlled trials that were identified in the literature, compliance was equal to or below 50% [11,12,13,14,15,16,17,18]. Compliance was also calculated after exclusion of those persons who stopped wearing hip protectors before the compliance measurement.…”

Section: Discussionmentioning

confidence: 99%

“…In five out of eight randomized controlled trials examining the effectiveness of external hip protectors that were identified in the literature, compliance with wearing hip protectors was lower or equal to 50% [11,12,13,14,15,16,17,18]. The method of measuring and calculating compliance, e.g.…”

Section: Introductionmentioning

confidence: 99%

The Amsterdam Hip Protector Study: compliance and determinants of compliance

Schoor¹,

Asma

Smit

et al. 2003

Osteoporos Int

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Effectiveness and acceptability of a newly designed hip protector: a pilot study

Cited by 65 publications

References 10 publications

Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis

Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis

Acceptance and Compliance with External Hip Protectors: A Systematic Review of the Literature

The Amsterdam Hip Protector Study: compliance and determinants of compliance

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