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How effective are hip protectors in preventing fractures in older people?
In older people living in nursing care facilities, providing a hip protector decreased the chance of a hip fracture slightly (11 fewer per 1000 people), may have increased the small chance of a pelvic fracture slightly (1 more per 1000 people) and probably had little or no effect on other fractures or falls. For those living at home, providing a hip protector probably had little or no effect on hip fractures. The incidence of adverse events while wearing hip protectors, including skin irritation, ranged from 0–5%. Adherence, particularly in the long term, was poor.
The quality of evidence for most outcomes was of moderate or low quality primarily due to risk of bias and imprecise results because of few fracture events.
Older people living in nursing care facilities or older adults living at home are at high risk of falling, and a hip fracture may occur after a fall. Hip protectors have been advocated as a means to reduce the risk of hip fracture.
Santesso N et al. Hip protectors for preventing hip fractures in older people. Cochrane Reviews, 2014, Issue 3. Art. No.: CD001255.DOI: 10.1002/14651858. CD001255.pub5. This review contains 19 studies involving approximately 17,000 participants (mean age range 78–86 years).
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
