Hip protectors to prevent hip fractures - a waste of time and money?

Abstract:<br/>Background: An estimated 30-60% of older<br/>adults fall every year and about 1% of falls result in a hip fracture. Hip fracture is a serious and growing problem, with a 3-10 fold rise in worldwide incidence predicted by 2050 (Gullberg, et al 1997). Hip protectors are underwear with built in protection for the greater trochanter. They are designed to prevent hip fractures by dispersing or absorbing the force of a fall. Trials<br/>published to 2001 were broadly supportive of<br/>the effectiveness of hip protectors, and this<br/>was reflected in a Cochrane review in 2000.<br/>However, earlier trials were methodologically<br/>flawed and subsequent trials have not demonstrated effectiveness. The most recent Cochrane review describes only a marginal benefit (Parker et al, 2005). <br/>Review and Discussion: This presentation<br/>evaluates the current evidence for the use<br/>of hip protectors and discusses the use of<br/>that evidence by manufacturers, suppliers,<br/>professional groups and guideline developers.<br/>Interestingly, despite the limitations of the<br/>evidence base, most advice has been broadly<br/>supportive. Reasons for this are proposed<br/>and discussed in the context of a critique of<br/>evidence-based healthcare. protectors. However, the available evidence can be used in different ways and for different purposes by those with an interest in promoting<br/>the use of hip protectors. A conservative<br/>approach is warranted, where, if we cannot<br/>demonstrate that hip protectors work, we<br/>presume that they do not. This presentation will be of use to practitioners wanting to evaluate the evidence base for hip protectors (and other recommended interventions) on behalf of clients. It will also be of interest to policy makers who must assess the claims made for health care technologies as part of the decisionmaking process. <br/>Recommended reading:<br/>Gullberg B, Johnell O, Kanis JA (1997) Worldwide<br/>projections for hip fracture. Osteoporos<br/>Int. 7(5):407-13 .<br/>Parker MJ, Gillespie WJ, Gillespie LD (2005) Hip<br/>protectors for preventing hip fractures in older<br/>people. The Cochrane Database of Systematic<br/>Reviews Issue 3. Art. No.: CD001255.pub3. DOI:<br/>10.1002/14651858.CD001255.pub3.<br/>