Effect of a Multifactorial Fall Injury Prevention Intervention on Patient Well-Being: The STRIDE Study
| Autor: | Eleni A. Skokos, Jocelyn Wiggins, Maureen Fagan, Susan L. Greenspan, Pamela W. Duncan, Patricia C. Dykes, Neil B. Alexander, Can Meng, Fred C. Ko, Lillian Min, Jeremy N. Rich, Todd M. Manini, Lori Goehring, Heather G. Allore, Siobhan K McMahon, Thomas M. Gill, Joanne M. McGloin, Jeanne A. Teresi, David B. Reuben, Peter Peduzzi, Albert W. Wu, Shehzad Basaria, Rosaly Correa-de-Araujo, Denise Esserman, Chad Boult, Nancy K. Latham, Neil M. Resnick, Erich J. Greene, Elena Volpi, Thomas G. Travison, Katy L. B. Araujo, Martha B. Carnie, Carri Casteel, Michael E. Miller, Jay Magaziner, Charles Lu, Stephen C. Waring, Robert B. Wallace, Thomas W. Storer, Peter Charpentier, David A. Ganz, Jerry H. Gurwitz, Catherine Hanson, Priscilla K. Gazarian, Shalender Bhasin, James Dziura |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Aging Poison control 030204 cardiovascular system & hematology Anxiety Suicide prevention Medical and Health Sciences 0302 clinical medicine 7.1 Individual care needs well-being 80 and over Medicine 030212 general & internal medicine Depression (differential diagnoses) Cancer Aged 80 and over Depression Rehabilitation Injuries and accidents Mental Health Female Independent Living Patient Safety medicine.symptom fall injury prevention Patients Clinical Trials and Supportive Activities STRIDE Risk Assessment Nurse's Role Article 03 medical and health sciences Clinical Research Intervention (counseling) Injury prevention Humans Patient Reported Outcome Measures Aged Primary Health Care business.industry Prevention Confidence interval Brain Disorders pragmatic trials Geriatrics older persons Injury (total) Accidents/Adverse Effects Accidental Falls Management of diseases and conditions Geriatrics and Gerontology business Demography |
| Zdroj: | Journal of the American Geriatrics Society, vol 69, iss 1 J Am Geriatr Soc |
| Popis: | Author(s): Gill, Thomas M; Bhasin, Shalender; Reuben, David B; Latham, Nancy K; Araujo, Katy; Ganz, David A; Boult, Chad; Wu, Albert W; Magaziner, Jay; Alexander, Neil; Wallace, Robert B; Miller, Michael E; Travison, Thomas G; Greenspan, Susan L; Gurwitz, Jerry H; Rich, Jeremy; Volpi, Elena; Waring, Stephen C; Manini, Todd M; Min, Lillian C; Teresi, Jeanne; Dykes, Patricia C; McMahon, Siobhan; McGloin, Joanne M; Skokos, Eleni A; Charpentier, Peter; Basaria, Shehzad; Duncan, Pamela W; Storer, Thomas W; Gazarian, Priscilla; Allore, Heather G; Dziura, James; Esserman, Denise; Carnie, Martha B; Hanson, Catherine; Ko, Fred; Resnick, Neil M; Wiggins, Jocelyn; Lu, Charles; Meng, Can; Goehring, Lori; Fagan, Maureen; Correa-de-Araujo, Rosaly; Casteel, Carri; Peduzzi, Peter; Greene, Erich J | Abstract: Background/objectivesIn the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study, a multifactorial intervention was associated with a nonsignificant 8% reduction in time to first serious fall injury but a significant 10% reduction in time to first self-reported fall injury relative to enhanced usual care. The effect of the intervention on other outcomes important to patients has not yet been reported. We aimed to evaluate the effect of the intervention on patient well-being including concern about falling, anxiety, depression, physical function, and disability.DesignPragmatic cluster-randomized trial of 5,451 community-living persons at high risk for serious fall injuries.SettingA total of 86 primary care practices within 10 U.S. healthcare systems.ParticipantsA random subsample of 743 persons aged 75 and older.MeasurementsThe well-being measures, assessed at baseline, 12 months, and 24 months, included a modified version of the Fall Efficacy Scale, Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scales, and Late-Life Function and Disability Instrument.ResultsParticipants in the intervention (n = 384) and control groups (n = 359) were comparable in age: mean (standard deviation) of 81.9 (4.7) versus 81.8 (5.0) years. Mean scores were similar between groups at 12 and 24 months for concern about falling, physical function, and disability, whereas the intervention group's mean scores on anxiety and depression were .7 points lower (i.e., better) at 12 months and .6 to .8 points lower at 24 months. For each of these outcomes, differences between the groups' adjusted least square mean changes from baseline to 12 and 24 months, respectively, were quantitatively small. The overall difference in means between groups over 2 years was statistically significant only for depression, favoring the intervention: -1.19 (99% confidence interval, -2.36 to -.02), with 3.5 points representing a minimally important difference.ConclusionsSTRIDE's multifactorial intervention to reduce fall injuries was not associated with clinically meaningful improvements in patient well-being. |
| Databáze: | OpenAIRE |
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