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A structured education programme increased hip protector use and may reduce hip fractures in nursing homes

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QUESTION: In elderly nursing home residents, does a structured education programme designed to increase use of hip protectors reduce the number of hip fractures more than usual care?


Cluster randomised (allocation concealed), unblinded, controlled trial with 18 months of follow up.


42 nursing homes in Hamburg, Germany.


942 nursing home residents (in 49 nursing home clusters) who were ≥70 years of age (mean age 87 y, 86% women), not bedridden, and living in the nursing home for >3 months. All patients and clusters were included in the analysis.


25 nursing home clusters (n=459) were allocated to a structured education programme designed to increase hip protector use. Staff from each cluster attended a 60–90 minute educational session (mean 12 staff/cluster) on the risk of hip fracture and related morbidity, strategies to prevent falls and fractures, effectiveness of hip protectors, aspects known to interfere with hip protector use, and strategies for successful implementation. At least 1 nurse/cluster then delivered the educational programme to nursing home residents individually or in small groups. Free hip protectors were provided (3 protectors/resident). 24 nursing home clusters (n=483) were allocated to usual care, in which a designated coordinator received brief information and …

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  • Sources of funding: Public Health Research Network Northern Germany and Rölke Pharma provided the hip protectors.

  • For correspondence: Professor I Mühlhauser, Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany. ingrid_muehlhauser{at}