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

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.

journal_name

J Am Med Dir Assoc

journal_title

Journal of the American Medical Directors Association

authors

Cameron ID,Kurrle SE,Quine S,Sambrook PN,March L,Chan DK,Lockwood K,Cook B,Schaafsma FF

doi

10.1016/j.jamda.2010.02.010

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

50-7

issue

eissn

1525-8610

issn

1538-9375

pii

S1525-8610(10)00067-8

journal_volume

pub_type

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