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Community-based intervention to optimise falls risk management: a randomised controlled trial

in
Publisher: 
Oxford University Press on behalf of the British Geriatrics Society
Author: 
Sharon Straus
Date published: 
29 September, 2009
Region: 
International

Publication type: 
research
Publication link: 
Community-based intervention to optimise falls risk management: a randomised controlled trial
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St. Michael's Hospital, 30 Bond Street, Shuter 2-026, Toronto, Ontario M5B 1W8, Canada

Address correspondence to: S. Straus. Tel: (+1)416 864 3068; Fax: (+1) 416 865 5805. E-mail: sharon.straus@utoronto.ca

Background: falls are the leading causes of accidental death and fragility fractures in older adults. Interventions that assess and reduce falls risk are underutilised.

Objective: to evaluate the impact of a multifaceted community-based programme aimed at optimising evidence-based management of patients at risk for fall-related fractures.

Design: this was a randomised trial performed from 2003 to 2006.

Setting: community-based intervention in Ontario, Canada

Participants: eligible patients were community-dwelling, aged ≥55 years and identified to be at risk for fall-related fractures. A total of 201 patients were allocated to the intervention group or to usual care.

Intervention: components of the intervention included assessment of falls risk, functional status and home environment, and patient education.

Measurements: primary outcome was the implementation of appropriate falls risk assessment at 6 months. Secondary outcomes included falls and fractures at 6 and 12 months.

Results: the mean age of participants was 72 years, and 41% had fallen with injury in the previous year. Compared to usual care, the intervention increased the number of referrals made to physiotherapy [21% (21/101) vs 6.0% (6/100); relative risk (RR) 3.47, 95% confidence interval (CI) 1.46–8.22] and occupational therapy [15% (15/101) vs 0%; RR 30.7, 95% CI 1.86 to >500]. At 12 months, the number of falls in the intervention group was greater than in the usual care group [23% (23/101) vs 11% (11/100); RR 2.07, 95% CI 1.07–4.02].

Conclusions: compared to usual care, a multi-faceted intervention increased referrals to physiotherapy and occupational therapy but did not reduce risk of falls. Similar falls reduction interventions cannot be recommended based on the results of this study.

 

Keywords: falls assessment and prevention, knowledge translation, elderly

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