Hip Fractures Clinical Trial
Official title:
Trochanteric Padding to Prevent Hip Fractures
HIP PRO is a multicenter randomized, controlled trial of an energy absorbing and distributing padding system designed to reduce the incidence of hip fractures in 546 nursing home (NH) residents. The trial is being conducted in three geographic regions of the US: Boston, St. Louis, and Baltimore. Non bed- or chair-bound residents over the age of 65 are given protective underwear containing a single pocket and hip pad so that each resident becomes his/her own control. During the trial, hip fracture incidence will be compared in padded and unpadded hips using an intent to treat analysis. A secondary aim is to identify resident and facility factors contributing to non-adherence with the use of the hip protector.
The HIP PRO Study is a randomized, controlled trial of the efficacy of a trochanteric
padding system in the reduction of hip fractures in nursing home residents over the age of
65 in up to 45 nursing homes in three regions: Boston, MA, St. Louis, MO, and Baltimore, MD.
Eligible residents of these facilities will be screened and then evaluated during a two week
run-in period during which a hip protection compliance rate of at least 67% will be required
for enrollment. Recruitment of all eligible residents entering each nursing home will
continue throughout the 3.5 year follow-up period.
Each subject will be given a set of 4-6 protective underwear containing a single pocket and
protective pad so that each resident becomes his/her own control. The side to be protected
will be based on the randomization of nursing home facilities to either right or left-sided
hip protection. The hip protection underwear is designed so that it may be worn during the
day and while in bed at night. Several types of underwear have been designed for residents
with special needs (e.g. incontinence, dementia). Compliance and efficacy are monitored at
least three times weekly across all three nursing shifts.
A hip fracture adjudication committee, blinded to the side of the fracture, will review all
information (including hospital records and radiologists' reports or hip radiographs) and
issue a decision on whether a fracture has occurred. Primary analyses will be performed
using an "intention to treat" approach. Secondary analyses will investigate resident and
nursing home factors associated with hip protection compliance and effectiveness. An
independent Data and Safety Monitoring Board (DSMB) has been convened and will review hip
fracture rates and adverse event data at regular intervals.
Institutions participating in HIP PRO are: a Data Coordinating Center at Maryland Medical
Research Institute in Baltimore, MD; three Clinical Centers at Washington University School
of Medicine in St. Louis, MO, the University of Maryland in Baltimore, MD with the
University of North Carolina in Chapel Hill, NC, and the Hebrew Rehabilitation Center for
Aged in Boston, MA. The Data Coordinating Center will direct the overall administrative
management of the trial.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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