Falls prevention at GP practices: a description of daily practice

Abstract

Background General practitioners (GPs) can be considered the designated professionals to identify high fall risk and to guide older people to fall preventive care. Currently it is not exactly known how GPs treat this risk. This study aims to investigate GPs’ daily practice regarding fall preventive care for frail older patients. Methods Sixty-five GPs from 32 Dutch practices participated in this study for a period of 12 months. When a GP entered specific International Classification of Primary Care-codes related to frailty and/or high fall risk in their Electronic Health Records, a pop-up appeared asking “Is this patient frail?”. If the GP confirmed this, the GP completed a short questionnaire about patient’s fall history and fear of falling (FOF), and the fall preventive care provided. Results The GPs completed questionnaires regarding 1394 frail older patients aged ≥75. Of 20% of these patients, the GPs did not know whether they had experienced a fall or not. The GPs did not know whether a FOF existed in even more patients (29%). Of the patients with a fall history and/or a FOF (N = 726), 37% (N = 271) received fall preventive care. Two main reasons for not offering fall preventive care to these patients were: I) the patient finds treatment too intensive or too much of a hassle (37%), and II) the GP identified a high fall risk but the patient did not acknowledge this (14%). When patients were treated for high fall risk, the GP and the physiotherapist were the most frequently involved health care providers. The involved health care providers most often treated mobility limitations, cardiovascular risk factors, and FOF. Conclusions The results from this study show that GPs were frequently not aware of their frail patient’s fall history and/or FOF and that the majority of the frail older patients with a fall history and/or FOF did not receive fall preventive care. Developing systematic screening strategies for the primary care setting enhancing the identification of high fall risk and the provision of fall preventive care may improve patients’ quality of life and reduce health care costs.

App-Based Evaluation of Older People’s Fall Risk Using the mHealth App Lindera Mobility Analysis: Exploratory Study

“…Using LIN or other medical devices with the ability to identify fall risks in older people while involving health professionals offers great potential. In 2021, Meekes et al [35] studied the level of information general practitioners (GPs) had available for any of their patients with frailty about their fall history as well as the occurrence of fear of falling. In their study, GPs had no information about fall history in 668 (48%) of the affected patients [35].…”

Involvement of Older Adults, the Golden Resources, as a Primary Measure for Fall Prevention

“…However, studies investigating healthcare professionals’ views on fall prevention show examples of barriers such as time, priorities, high costs, and lack of knowledge. 13 These barriers may mean that a majority of patients with fall risk and fall history do not receive fall-preventive care, especially not appropriately individualized and evidence-based fall-preventive care. 13 In addition, when fall prevention is provided there is a challenge with fidelity.…”

“… 13 These barriers may mean that a majority of patients with fall risk and fall history do not receive fall-preventive care, especially not appropriately individualized and evidence-based fall-preventive care. 13 In addition, when fall prevention is provided there is a challenge with fidelity. A lack of fidelity often includes modified interventions, based on common barriers such as resource availability, rather than science.…”