The commentary by Griffiths regarding the Cochrane review on the effectiveness of hip protectors for reducing hip fractures published in the January 2005 issue of Evidence-Based Nursing¹ highlights important methodological considerations that may account for the failure of this review to demonstrate a reduction in fractures among elderly people living in residential care. Although we concur with Griffiths’ conclusion that it is premature to advise patients to stop using hip protectors, we would like to advance 3 other important considerations.

Firstly, falls among older adults are often multifactorial, and therefore, prevention requires a multiple intervention approach.² That is, multiple strategy interventions that target risk factors for falls at individual, health provider, and organisational levels should be offered. If hip protectors are offered as part of a multiple intervention programme for falls prevention, elderly people may be reminded that hip protectors alone do not prevent falls and perhaps dissuaded from developing a false sense of confidence when wearing hip protectors and taking undue risks. Secondly, a review of the studies included in the Cochrane review by Parker et al indicated that many of the staff training interventions described were brief and not informed by appropriate theory. The study by Meyer et al …