Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up

Berggren, Monica; Stenvall, Michael; Gustafson, Yngve

doi:10.1007/s00198-007-0507-9

Cited by 56 publications

(38 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of these is a study of whole body vibration in care facilities (Tallon 2013), another is likely to be an additional conference abstract of an already included study (Frohnhofen 2013), and the third is a thesis for which no study publication has been identified (MacRitchie 2001). Five newly published studies were identified in the top-up search and await full assessment (Dever 2016; Hewitt 2014; Raymond 2017; Van der Linden 2017; Wylie 2017). …”

Section: Resultsmentioning

confidence: 99%

“…Five newly published studies that were identified in the top-up search in August 2017 await classification (Dever 2016; Hewitt 2014; Raymond 2017; Van der Linden 2017; Wylie 2017). This was a pragmatic decision taken in view of the delay that would have resulted from their likely inclusion and after consideration of the potential impact of these trials on review findings.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Interventions for preventing falls in older people in care facilities and hospitals

Cameron

Dyer²,

Panagoda

et al. 2018

Cochrane Database of Systematic Reviews

345

370

View full text Add to dashboard Cite

Background Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012. Objectives To assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. Selection criteria Randomised controlled trials of interventions for preventing falls in older people in residential or nursing care facilities, or hospitals. Data collection and analysis One review author screened abstracts; two review authors screened full‐text articles for inclusion. Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction. We calculated rate ratios (RaR) with 95% confidence intervals (CIs) for rate of falls and risk ratios (RRs) and 95% CIs for outcomes such as risk of falling (number of people falling). We pooled results where appropriate. We used GRADE to assess the quality of evidence. Main results Thirty‐five new trials (77,869 participants) were included in this update. Overall, we included 95 trials (138,164 participants), 71 (40,374 participants; mean age 84 years; 75% women) in care facilities and 24 (97,790 participants; mean age 78 years; 52% women) in hospitals. The majority of trials were at high risk of bias in one or more domains, mostly relating to lack of blinding. With few exceptions, the quality of evidence for individual interventions in either setting was generally rated as low or very low. Risk of fracture and adverse events were generally poorly reported and, where reported, the evidence was very low‐quality, which means that we are uncertain of the estimates. Only the falls outcomes for the main comparisons are reported here. Care facilities Seventeen trials compared exercise with control (typically usual care alone). We are uncertain of the effect of exercise on rate of falls (RaR 0.93, 95% CI 0.72 to 1.20; 2002 participants, 10 studies; I² = 76%; very low‐quality evidence). Exercise may make little or no difference to the risk of falling (RR 1.02, 95% CI 0.88 to 1.18; 2090 participants, 10 studies; I² = 23%; low‐quality evidence). There is low‐quality evidence that general medication review (tested in 12 trials) may make little or no difference to the rate of falls (RaR 0.93, 95% CI 0.64 to 1.35; 2409 participants, 6 studies; I² = 93%) or the risk of falling (RR 0.93, 95% CI 0.80 to 1.09; 5139 participants, 6 studies; I² = 48%). There is moderate‐quality evidence that vitamin D supplementation (4512 particip...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interventions for preventing falls in older people in care facilities and hospitals

Cameron

Dyer²,

Panagoda

et al. 2018

Cochrane Database of Systematic Reviews

345

370

View full text Add to dashboard Cite

show abstract

“…However, although there is substantial evidence that fall prevention strategies reduce the number of falls, even in patients with dementia after hip fracture, less evidence is available about their effectiveness in preventing fractures [73][74][75][76][77][78]. Many of the established risk factors for falls have been shown to increase fracture risk as well [79], and this suggests the need for a coordinated programme, with an integrated approach for fall and fracture prevention.…”

Section: Falls Assessmentmentioning

confidence: 98%

Coordinator-based systems for secondary prevention in fragility fracture patients

et al. 2011

View full text Add to dashboard Cite

The underlying causes of incident fractures--bone fragility and the tendency to fall--remain under-diagnosed and under-treated. This care gap in secondary prevention must be addressed to minimise both the debilitating consequences of subsequent fractures for patients and the associated economic burden to healthcare systems. Clinical systems aimed at ensuring appropriate management of patients following fracture have been developed around the world. A systematic review of the literature showed that 65% of systems reported include a dedicated coordinator who acts as the link between the orthopaedic team, the osteoporosis and falls services, the patient and the primary care physician. Coordinator-based systems facilitate bone mineral density testing, osteoporosis education and care in patients following a fragility fracture and have been shown to be cost-saving. Other success factors included a fracture registry and a database to monitor the care provided to the fracture patient. Implementation of such a system requires an audit of existing arrangements, creation of a network of healthcare professionals with clearly defined roles and the identification of a 'medical champion' to lead the project. A business case is needed to acquire the necessary funding. Incremental, achievable targets should be identified. Clinical pathways should be supported by evidence-based recommendations from national or regional guidelines. Endorsement of the proposed model within national healthcare policies and advocacy programmes can achieve alignment of the objectives of policy makers, professionals and patients. Successful transformation of care relies upon consensus amongst all participants in the multi-disciplinary team that cares for fragility fracture patients.

show abstract

“…It should be noted that patients in this series were most likely to have suffered injury outside of normal daytime working hours, and only four falls were witnessed. Inpatient falls can be prevented by nursing high-risk patients in supervised areas, active identification causative factors, and timely assessment of medical issues or post-operative complications [13,16]. After sustaining a FNOF, 100% of patients received a falls assessment which is comparable to a national figure of 94% of patients [1].…”

Section: Day and Time Of Fallmentioning

confidence: 99%

The inpatient fracture neck of femur: An important subgroup of patients

Green¹,

Zeiton²,

Foulkes³

et al. 2014

Injury

View full text Add to dashboard Cite

Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up

Cited by 56 publications

References 35 publications

Interventions for preventing falls in older people in care facilities and hospitals

Interventions for preventing falls in older people in care facilities and hospitals

Coordinator-based systems for secondary prevention in fragility fracture patients

The inpatient fracture neck of femur: An important subgroup of patients

Contact Info

Product

Resources

About