HIPCARE

Older patients are particularly likely to break a bone (fracture) because of a fall from a standing height, as their bones are weakened by osteoporosis. These fragility fractures have serious consequences and outcomes may be even worse in settings with limited healthcare resources. Asia is particularly affected by rapidly ageing populations with many more hip fractures expected in the next decade along with increasing associated healthcare costs. Improving care for patients with hip fracture is therefore a priority in this region.

Looking after patients following a hip fracture requires healthcare workers from many different backgrounds to work together. These multidisciplinary teams include surgeons, doctors specialising in looking after older patients, nurses and therapists, each with defined roles and responsibilities. In the UK, this team approach has reduced the number of patients dying and improved quality-of-life after hip fracture. It also reduced time spent in hospital and associated healthcare costs.

Our aim is to improve quality-of-life for hip fracture patients and to reduce healthcare costs in Low and Middle Income Countries (LMIC) in Asia.

This study is about testing the benefits of 'HIPCARE' which is a multidisciplinary care package for hip fracture patients in five countries in Asia (India, Thailand, Vietnam, Nepal and the Philippines). HIPCARE has three main components: early surgery to fix the hip fracture, early assessment by a medical doctor and early walking with the help of a therapist to speed recovery. Having refined the training materials to make the HIPCARE package specific to each country in the study, we will do a large study to compare HIPCARE with usual care for hip fracture patients in 40 hospitals across the five countries in the study. We want to see if the HIPCARE intervention improves the quality-of-life for hip fracture patients in each country and whether it reduces healthcare costs, compared with usual care. The study takes place from November 2022 until October 2026.

Study design

A cluster randomised controlled trial with embedded process evaluation