To the Editor: Hip protectors may be an effective means of preventing hip fracture in residents of aged-care facilities, if there is adequate compliance with their use.1 Research studies conducted in the Northern Sydney and Illawarra health regions2,3 have found that, if a hip protector is worn at the time of a fall, the chance of hip fracture is reduced by about 80%. We wished to determine the extent to which hip protector use had become a routine part of healthcare in residential aged-care facilities generally, and whether there was a greater uptake of their use in areas where the research had been conducted.

A brief questionnaire about hip protector use was sent to all residential aged-care facilities in the Northern and South Eastern Sydney health regions, and the region covered by the New South Wales Southern Area Health Service. The response rate was 60% in each region, and responses are summarised in the Box. Only 30 residential aged-care facilities participated in the previous study, and the results indicate that use is now much more widespread. Another contrast is that, in the research study, hip protectors were provided free of charge, whereas most current users pay for hip protectors.

Overall, the survey indicates that 61% of aged-care facilities across three regions of NSW are either using hip protectors or have used them in the past. Hip protector use was similar in Northern Sydney and Southern NSW; however, comparing Northern Sydney (where previous research had been conducted) with the other two regions combined showed a greater prevalence related to conducting previous research.

Issues such as cost, laundering of the hip protectors, and comfort are seen as major barriers to their use, but many aged-care facilities continue to use them for selected residents at high risk of hip fracture. It is our impression that the more residents within a facility who wear hip protectors, the better the adherence to hip protector use and the management of these issues. It is also evident that hip protector research encourages use of hip protectors. We are unsure of the mechanism involved, but believe that knowledge and enthusiasm for use of hip protectors is spread by word of mouth between health professionals, staff working in nursing homes and hostels and, in some cases, through relatives of the residents of residential aged-care facilities.