Lack of Effectiveness of a Multidisciplinary Fall‐Prevention Program in Elderly People at Risk: A Randomized, Controlled Trial

Abstract

The multidisciplinary fall-prevention program was not effective in preventing falls and functional decline in this Dutch healthcare setting. Implementing the program in its present form in the Netherlands is not recommended. This trial shows that there can be considerable discrepancy between the "ideal" (experimental) version of a program and the implemented version of the same program. The importance of implementation research in assessing feasibility and effectiveness of such a program in a specific healthcare setting is therefore stressed.

Effects of an adapted physical activity program on the physical condition of elderly women: an analysis of efficiency

“…The failure of measures such as weight or BMI in differentiating efficiency could support current evidence in favor of disregarding measures such as BMI as an indicator of risk of mortality in the elderly, with other factors, such as a sedentary lifestyle, being more important 52 . These results, in agreement with those of other authors 53 , suggest the importance of investigating the target population's health needs, activity dose, and demographics before implementing programs, especially if differences between population features have been identified 9,21,54 . The establishment of specific groups of individuals may mitigate the discrepancy between ideal versions of programs and their practical implementation.…”

Lesões graves em vítimas de queda da própria altura

“…In spite of some debate, prevention programs seem to have positive effect, but their application is difficult. 19,21,[26][27][28][29][30] However, we have observed, in our date, that only 32.1% of FSL victims are aged over 60. In spite of its severity among the elderly, this trauma mechanism involves a greater number of patients with their own characteristics.…”

Comparison of different strategies of referral to a fall clinic: How to achieve an optimal casemix?

“…Both recruitment strategies may be efficient because multiple risk factor assessment and subsequent interventions may reduce monthly falls by 30% (9,10). However, trials show conflicting outcomes when the effect of multifactorial prevention strategies is studied (11)(12)(13)(14)(15). These differences are probably directly related to the casemix included in these trials and thus are dependent on the system of recruitment and referral.…”

“…In the successful PROFET study community living older people presenting to a hospital emergency department after a fall were recruited by systematic identification by a geriatrician, excluding patients with cognitive impairment (11). An unsuccessful Dutch trial was different in the selection method by including participants attending the GP-Cooperative instead of only the ED and lacking the systematic identification by a geriatrician (14). For instance, the percentage of recurrent falls was only 27% in the PROFET study versus 49% in the Dutch trial, pointing out the difference in the target population.…”