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Tuesday, July 24, 2007

Hip protection doesn't stop breaks

By Alice Dembner, Globe Staff

Pads designed to protect human hips do not help the most vulnerable patients avoid hip fractures, according to a study led by a Boston researcher that is being published tomorrow in the Journal of the American Medical Association.

The study tested specially designed hip protectors in more than 1,000 residents of nursing homes in greater Boston, St. Louis and Baltimore. It was halted after 20 months when it became clear that the pads were offering no protection.

Hip fracture in the elderly can trigger a cascade of medical problems that result in the death of nearly 30 percent of patients a year after the break. Most of the fractures result from falls, and falls are particularly common among nursing home residents.

Led by Dr. Douglas Kiel, director of medical research at Hebrew SeniorLife, the study was unique in its design -- with patients wearing protectors on one hip and not the other, using special undergarments. The research was an attempt to provide a definitive answer after a number of other studies that offered conflicting results.

But in an accompanying editorial, two doctors from Finland say more research is still needed, because there are so many different hip protectors available and because wearing the pads on one hip and not the other might have physically unbalanced the residents.

Kiel and two other authors drew fire today from the Associated Press for not disclosing to the journal their financial ties to companies that make bone-protecting drugs. Kiel and JAMA’s editor, Dr. Catherine DeAngelis, called the drug ties irrelevant to the study.

Kiel told the AP that the drugs take at least a year to work and therefore are not ideal for nursing home residents. The study also did not attempt to compare the effects of drugs to hip protectors.

"We have no financial disclosures with hip protectors," Kiel told the AP. "We were asked repeatedly by the editors whether we were following JAMA's full disclosures and we said yes."

Posted by Karen Weintraub at 04:00 PM
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