Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention--a randomised controlled trial.

Category Primary study
JournalAge and ageing
Year 2005

This article is included in 14 Systematic reviews Systematic reviews (14 references) 1 Broad synthesis Broad syntheses (1 reference)

This article is part of the following publication threads:
  • SAFER 2 [Syncope and falls in the emergency room] (2 documents)
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OBJECTIVES:

To determine the effectiveness of multifactorial intervention to prevent falls in cognitively intact older persons with recurrent falls.

DESIGN:

Randomised controlled trial of multifactorial (medical, physiotherapy and occupational therapy) post-fall assessment and intervention compared with conventional care.

SETTING:

Accident & Emergency departments in a university teaching hospital and associated district general hospital.

SUBJECTS:

313 cognitively intact men and women aged over 65 years presenting to Accident & Emergency with a fall or fall-related injury and at least one additional fall in the preceding year; 159 randomised to assessment and intervention and 154 to conventional care. Outcome measures: primary outcome was the number of falls and fallers in 1 year after recruitment. Secondary outcomes included injury rates, fall-related hospital admissions, mortality and fear of falling.

RESULTS:

There were 36% fewer falls in the intervention group (relative risk 0.64, 95% confidence interval 0.46-0.90). The proportion of subjects continuing to fall (65% (94/144) compared with 68% (102/149) relative risk 0.95, 95% confidence interval 0.81-1.12), and the number of fall-related attendances and hospital admissions was not different between groups. Duration of hospital admission was reduced (mean difference admission duration 3.6 days, 95% confidence interval 0.1-7.6) and falls efficacy was better in the intervention group (mean difference in Activities Specific Balance Confidence Score of 7.5, 95% confidence interval 0.72-14.2).

CONCLUSION:

Multifactorial intervention is effective at reducing the fall burden in cognitively intact older persons with recurrent falls attending Accident & Emergency, but does not reduce the proportion of subjects still falling.
Epistemonikos ID: 5d8464a57a4e6e3ef6ca9abf53066e047c84908d
First added on: Jun 08, 2011