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

Ciaschini, Patricia M; Straus, SE; Dolovich, Lisa; Goeree, R; Leung, Ka Man; Woods, Carol R; Zimmerman, Greg; Majumdar, Sumit R.; Spadafora, Silvana; Fera, LA; Lee, H.N.

doi:10.1093/ageing/afp176

Cited by 29 publications

(53 citation statements)

References 26 publications

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“…Falls are common in older persons and can cause notable decreases of quality of life due to fear of falling, restricted mobility and loss of autonomy as well as large costs for health care systems [1-3,50,51]. The available evidence suggests that currently available interventions to reduce falls have limited effectiveness and should target on risk population [2,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…Based on the available data it is estimated that about 30% to 40% of community-dwelling older persons experience at least one fall per year with a high proportion falling more often than once [1-3]. These figures might be even underestimates.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, psychological consequences such as fear of falling induce a negative vicious circle due to restriction of physical activities, thus decreasing quality of life and accelerating the process of functional decline of the aging process [14,15]. Given the demographic changes in many countries the prevalence of fall-related problems is likely to further increase in future [1,9]. …”

Section: Introductionmentioning

confidence: 99%

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An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls]

Blank¹,

Freiberger²,

Siegrist³

et al. 2011

BMC Geriatr

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BackgroundPrevention of falls in the elderly is a public health target in many countries around the world. While a large number of trials have investigated the effectiveness of fall prevention programs, few focussed on interventions embedded in the general practice setting and its related network. In the Prevent Falls (PreFalls) trial we aim to investigate the effectiveness of a pre-tested multi-modal intervention compared to usual care in this setting.Methods/DesignPreFalls is a controlled multicenter prospective study with cluster-randomized allocation of about 40 general practices to an experimental or a control group. We aim to include 382 community dwelling persons aged 65 and older with an increased risk of falling. All participating general practitioners are trained to systematically assess the risk of falls using a set of validated tests. Patients from intervention practices are invited to participate in a 16-weeks exercise program with focus on fall prevention delivered by specifically trained local physiotherapists. Patients from practices allocated to the control group receive usual care. Main outcome measure is the number of falls per individual in the first 12 months (analysis by negative binomial regression). Secondary outcomes include falls in the second year, the proportion of participants falling in the first and the second year, falls associated with injury, risk of falls, fear of falling, physical activity and quality of life.DiscussionReducing falls in the elderly remains a major challenge. We believe that with its strong focus on a both systematic and realistic fall prevention strategy adapted to primary care setting PreFalls will be a valuable addition to the scientific literature in the field.Trial registrationNCT01032252

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls]

Blank¹,

Freiberger²,

Siegrist³

et al. 2011

BMC Geriatr

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“…Mais de um terço dos idosos de comunidade com 65 anos de idade e mais caem anualmente, e esta proporção aumenta para 32-42% entre aqueles com mais de 70 anos, atingindo 50% dos idosos com 80 anos ou mais; 15 em metade desses casos, as quedas são recorrentes. 16 A ocorrência deste evento se amplia com o avanço da idade e o nível de fragilidade; assim, os idosos institucionalizados têm maior risco de cair, se comparados com aqueles residentes de comunidade.…”

Section: Prevalência E Consequências Associadas àS Quedasunclassified

Quedas: conceitos, frequências e aplicações à assistência ao idoso. Revisão da literatura

Falsarella

Gasparotto

Coimbra

2014

Rev. bras. geriatr. gerontol.

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ResumoRealizou-se revisão da literatura sobre quedas em idosos de comunidade, identificando prevalência, fatores de risco e consequências associadas ao cair, bem como triagem, avaliação e medidas preventivas às quedas na velhice. Foram selecionadas publicações indexadas nas bases de dados Medical Literature Analysis e Retrieval System Online (MEDLINE), por meio do PubMed; Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SciELO), relativas ao período de 2008 a 2012, sendo analisadas 41 referências. As evidências levantadas neste estudo destacam as quedas como condição de grande complexidade e que impõe grande desafio para idosos e profissionais da saúde. Ressalta-se a importância da identificação e do manejo dos fatores determinantes e das consequências associadas ao cair, juntamente com o delineamento de estratégias preventivas multifatoriais frente aos idosos vulneráveis ao cair e entre os idosos com história de quedas recorrentes. AbstractA review of the literature on falls in community-dwelling elderly was conducted, identifying prevalence, risk factors and consequences associated to falls, as well as screening, assessment and preventive measures to falls in old age. We selected publications indexed in the following data bases: Medical Literature Analysis and Retrieval System Online (MEDLINE), both consulted through PubMed; (Lilacs) Latin-American and Caribean Science of Health) and Scientific Electronic Library Online (SciELO), from 2008 to 2012; 41 references were analyzed. The evidences surveyed in this study highlight falls as a condition of great complexity that imposes great challenge for elderly and health professionals. We emphasize the importance of identification and management of determinant factors and consequences associated with falls, coupled with the design of multifactorial preventive strategies for elderly vulnerable to falls and among those with history of recurrent falls.Palavras-chave: Idoso. Acidentes por Quedas. Prevenção.

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“…15 A strategy to implement the guidelines of Osteoporosis Canada in a community setting was recently studied. 16 The primary outcome of this randomized trial was appropriate use of medications for osteoporosis (i.e., instrumental knowledge) rather than fractures in patients (i.e., clinical outcome). The researchers felt that, because sufficient evidence exists to support use of medication for osteoporosis to prevent fragility fractures, they did not need to measure fractures as the primary outcome.…”

mentioning

confidence: 99%

Monitoring use of knowledge and evaluating outcomes

Straus

Tetroe²,

Graham³

et al. 2010

Canadian Medical Association Journal

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

Abstract: 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.

Cited by 29 publications

References 26 publications

An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls]

An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls]

Quedas: conceitos, frequências e aplicações à assistência ao idoso. Revisão da literatura

Monitoring use of knowledge and evaluating outcomes

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