Primary Prevention of Fragility Hip Fracture in High-Risk Elderly by Village Health Volunteers in Nan Province, Thailand

Objective: To evaluate the effectiveness of village health volunteers (VHVs) in providing home visits to high-risk elderly individuals in Nan Province, Thailand, to monitor and prevent new fragility hip fractures. The increasing incidence of hip fractures among the elderly in this region highlights the need for effective preventive measures. Materials and Methods: The present study was a prospective cohort study conducted in Nan Province, Thailand, between January 1, 2020, and December 31, 2023. The study population consisted of elderly Thai individuals aged 65 years and above with a FRAX hip score greater than 3% and no prior history of hip fragility fractures. The intervention involved home visits by VHVs at least once every six months for two years. Results: Of the 12,302 eligible participants, 9,215 (74.9%) received home visits, with an average of 2.4 visits per person. Four hundred seven participants (3.3%) experienced new hip fractures, with 198 (2.1%) in the home visit group and 209 (6.8%) in the non-home visit group. The key factors associated with new hip fractures included the history of non-hip fragility fractures, dementia, and non-home visits. Home visits by VHVs were associated with a 3.34 times lower risk of hip fractures compared to those not receiving home visits. Conclusion: The utilization of VHVs for home visits, particularly for at-risk individuals identified using the FRAX tool, is a significantly effective method for reducing the incidence of fragility hip fractures.