The Winchester falls project: a randomised controlled trial of secondary prevention of falls in older people
| Autor: | Thomas H S Dent, Steve George, Christopher J Gordon, Jim Rose, Scott Harris, Wendy Morotti, Claire Spice |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Aging medicine.medical_specialty Referral Poison control Day care law.invention Randomized controlled trial law Recurrence Risk Factors medicine Humans Cluster randomised controlled trial Risk factor Geriatric Assessment Aged Aged 80 and over Primary Health Care business.industry General Medicine Odds ratio Emergency department United Kingdom Physical therapy Accidental Falls Female Geriatrics and Gerontology business Day Care Medical |
| Zdroj: | Age and ageing. 38(1) |
| ISSN: | 1468-2834 |
| Popis: | Background: the mortality and morbidity of falls in older people is significant, with recurrent fallers being at an increased risk. The most effective way to reduce falls in this group is not clear. Objective: to determine the effectiveness of two interventions, one based in primary care and the other in secondary care, at preventing further falls in recurrent fallers. Design: cluster randomised controlled trial. Participants: sixty-five years or over, living in the community, two or more falls in the previous year and not presenting to an emergency department with index fall. Setting: Mid Hampshire, UK. Intervention:eighteengeneral practices were randomly allocated to one of three groups.The primary care groupwas assessed by nurses in the community, using a risk factor review and subsequent targeted referral to other professionals. The secondary care group received a multi-disciplinary assessment in a day hospital followed by identified appropriate interventions. The control group received usual care. Follow-up was for 1 year. Results: five hundred and five participants were recruited. Follow-up was completed in 83% (421/505). The proportion of participants who fell again was significantly lower in the secondary care group (75%, 158/210) compared to the control group [84%, 133/159, adjusted odds ratio (OR) 0.52 (95% CI 0.35‐0.79) P = 0.002]. The primary care group showed similar results to the control group [87%, 118/136, adjusted OR 1.17 (95% CI 0.57‐2.37) P = 0.673]. Conclusion: a structured multi-disciplinary assessment of recurrent fallers significantly reduced the number experiencing further falls, but a community-based nurse-led assessment with targeted referral to other professionals did not. |
| Databáze: | OpenAIRE |
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