THURSDAY, Jan. 9, 2003 (HealthDayNews) -- A program to induce nursing home residents to wear the shock-absorbing underwear called hip protectors cut the number of hip fractures by more than 40 percent, German researchers report.
That reduction could save a lot of lives. One of every three Americans over the age of 65 has a fall each year, says the Centers for Disease Control and Prevention, and many of those falls result in fractures, particularly of the hip. In 1996, 340,000 people were hospitalized because of hip fractures and 9,600 people died of a fall-related injury, the CDC says.
A study in the Jan. 11 issue of the British Medical Journal included 49 nursing homes in the Hamburg area. In 25 of them, residents got a 60- to 90-minute lecture/training session from nurses about the value of wearing hip protectors; no such sessions were conducted in the other 24 homes. The residents who got the lectures were also offered free hip protectors.
"The nurses were instructed to tell the residents to wear hip protectors and inform them of their value," says Gabriele Meyer, a research fellow at the Unit of Health Sciences and Education of the University of Hamburg and lead author of the report.
The talks persuaded 118 of the 459 residents to wear hip protectors; only 40 of the 483 residents who didn't get the lectures decided on their own to wear them.
Over the next 14 months, there were 21 hip fractures among those who got the lecture and 42 among those who didn't Meyer says. The number of hospital admissions in the protector-wearing group was 121, compared to 211 in the unprotected group. Those who wore the protectors saw their risk of fracture drop by 43 percent.
The study shows that telling nursing home residents about the value of hip protectors does increase their use, Meyer says. "Now we would like to educate speakers who would then educate other nurses, and so on," she says.
In the United States, one company that sells hip protectors is E-Pill, a Massachusetts firm that markets them as a sideline. The German study is the latest of a series to show their value, says Stefan Solvell, the company president.
The study Solvell likes to cite was done in Finland, which in 2000 reported an 84 percent decrease in hip fractures over a prolonged period. Nevertheless, the hip protector business is not very good, he says.
"The awareness level for hip protectors in the United States is very, very low," Solvell says. "Every day, we have physicians who never heard of them."
One problem is that Medicare and Medicaid do not reimburse for hip protectors, he says. A single hip protector can be bought for $89.95, but for practical purposes a user will need a three-unit set costing $174.95.
The only places in the world where hip protectors are regularly used are the Scandinavian countries and Australia, Solvell says. "In Scandinavia, hip protectors are standard practice for older patients with osteoporosis and a history of falls," he says.
Scandinavia is understandable, because much of the research that proved their value was done at the University of Copenhagen, but Australia is something of a mystery, Solvell says.
"The trouble with hip protectors is that people don't want to wear them," say Pam Holliday, a research associate at Sunnybrook and Women's College Health Sciences Center in Toronto. She recalls one research study of an easy-to-wear device's impact on falls and mobility. At the end of the first week, 80 percent of the long-term patients in the study were wearing the device. After a month, 68 percent were wearing it, and eventually use declined to 33 percent -- the same level reported in the Hamburg study.
"The evidence is fairly strong that they can reduce the number of hip fractures, and they seem to be cost-effective," Holliday says of hip protectors. The hope that their use will increase has been bolstered by the appearance of more products, she adds. While only two kinds of hip protector were available a few years ago, there now are six kinds on the market.
What To Do
Information on falls, the damage they do and their prevention is given by the Centers for Disease Control and Prevention or the National Osteoporosis Foundation.
For more on hip protectors, visit Johns Hopkins Health After 50.
