Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health-related quality of life
| Autor: | David A. Ganz, Anita H. Yuan, Erich J. Greene, Nancy K. Latham, Katy Araujo, Albert L. Siu, Jay Magaziner, Jerry H. Gurwitz, Albert W. Wu, Neil B. Alexander, Robert B. Wallace, Susan L. Greenspan, Jeremy Rich, Elena Volpi, Stephen C. Waring, Patricia C. Dykes, Fred Ko, Neil M. Resnick, Siobhan K. McMahon, Shehzad Basaria, Rixin Wang, Charles Lu, Denise Esserman, James Dziura, Michael E. Miller, Thomas G. Travison, Peter Peduzzi, Shalender Bhasin, David B. Reuben, Thomas M. Gill |
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| Rok vydání: | 2022 |
| Předmět: |
Aging
care management Clinical Trials and Supportive Activities Medical and Health Sciences Fractures Bone Clinical Research falls Humans Bone Aged Prevention Rehabilitation Injuries and accidents Hospitalization health-related quality of life Good Health and Well Being pragmatic trials Geriatrics Quality of Life older persons Injury (total) Accidents/Adverse Effects Independent Living Patient Safety Geriatrics and Gerontology Fractures |
| Zdroj: | Journal of the American Geriatrics Society, vol 70, iss 11 |
| Popis: | BackgroundFalls are common in older adults and can lead to severe injuries. The Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) trial cluster-randomized 86 primary care practices across 10 health systems to a multifactorial intervention to prevent fall injuries, delivered by registered nurses trained as falls care managers, or enhanced usual care. STRIDE enrolled 5451 community-dwelling older adults age ≥70 at increased fall injury risk.MethodsWe assessed fall-related outcomes via telephone interviews of participants (or proxies) every 4 months. At baseline, 12 and 24 months, we assessed health-related quality of life (HRQOL) using the EQ-5D-5L and EQ-VAS. We used Poisson models to assess intervention effects on falls, fall-related fractures, fall injuries leading to hospital admission, and fall injuries leading to medical attention. We used hierarchical longitudinal linear models to assess HRQOL.ResultsFor recurrent event models, intervention versus control incidence rate ratios were 0.97 (95% confidence interval [CI], 0.93-1.00; p= 0.048) for falls, 0.93 (95% CI, 0.80-1.08; p= 0.337) for self-reported fractures, 0.89 (95% CI, 0.73-1.07; p= 0.205) for adjudicated fractures, 0.91 (95% CI, 0.77-1.07; p= 0.263) for falls leading to hospital admission, and 0.97 (95% CI, 0.89-1.06; p= 0.477) for falls leading to medical attention. Similar effect sizes (non-significant) were obtained for dichotomous outcomes (e.g., participants with ≥1 events). The difference in least square mean change over time in EQ-5D-5L (intervention minus control) was 0.009 (95% CI, -0.002 to 0.019; p= 0.106) at 12 months and 0.005 (95% CI, -0.006 to 0.015; p= 0.384) at 24 months.ConclusionsAcross a standard set of outcomes typically reported in fall prevention studies, we observed modest improvements, one of which was statistically significant. Future work should focus on patient-, practice-, and organization-level operational strategies to increase the real-world effectiveness of interventions, and improving the ability to detect small but potentially meaningful clinical effects.Clinicaltrialsgov identifier: NCT02475850. |
| Databáze: | OpenAIRE |
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