PROFET (Prevention of falls in the elderly trial)
ID: 5675dda518d84e25bbff57aa
6 Documents
Close
6 References ( articles) loading Revert Studify

Primary study

Unclassified

Interdisciplinary assessment of elderly people presenting to A&E with a fall

blocked
Journal Age and ageing
Year 1998
Links DOI ageing.oxfordjournals
Loading references information
INTRODUCTION: Falls in elderly people are a major cause of mortality and carry with them substantial cost both to the individual and to health and allied services. There is no agreed approach to the management of falls within the UK but in view of their high prevalence, a clinically effective strategy is required, particularly if we are to achieve. The Health of the Nation target of a 33% reduction in deaths from home accidents in the over 65`s by the year 2005. METHODOLOGY: A randomised prospective controlled clinical study was undertaken to investigate the benefit of structured bidisciplinary (medical and OT) assessment of consecutive elderly patients (65 yrs and above) living in the community and presenting to A&E with a fall. Patients in the intervention group underwent a single detailed medical and occupational therapy assessment to identify remediable/modifiable risk factors for falls. Where further evaluation was required, the patient was referred to the relevant specialty . The primary endpoint was the number of subsequent falls in the lyr follow up period, identified by postal questionnaire. RESULTS: 397 patients were randomised to intervention or control group. Of those undergoing the medical assessment (86% of intervention group), a primary attributable cause was assigned in 77,5% of cases. Only 15,6% of medical assessments and 10% of OT assessments required no further action/intervention. At 12 months there was a significant reduction in the number of falls in the intervention group (173 v 484, p<0.001). In addition, there was a significant difference in functional ability (Barthel score 18 5 v 17.3:p<0.01) CONCLUSION: Structured prospective interdisciplinary assessment and management of older people presenting to A&E with falls is of clear benefit in the prevention of subsequent falls and in the preservation of functional ability.

Primary study

Unclassified

Predictors of falls - results from prevention of falls in the elderly trial (PROFET)

blocked
Journal Age and ageing
Year 1998
Links ageing.oxfordjournals
Loading references information

Primary study

Unclassified

Prevention of falls in the elderly trial (PROFET): a randomised controlled trial.

blocked
Journal Lancet
Year 1999
Links Pubmed DOI
Loading references information
BACKGROUND: Falls in elderly people are a common presenting complaint to accident and emergency departments. Current practice commonly focuses on the injury, with little systematic assessment of the underlying cause, functional consequences, and possibilities for future prevention. We undertook a randomised controlled study to assess the benefit of a structured inderdisciplinary assessment of people who have fallen in terms of further falls. METHODS: Eligible patients were aged 65 years and older, lived in the community, and presented to an accident and emergency department with a fall. Patients assigned to the intervention group (n=184) underwent a detailed medical and occupational-therapy assessment with referral to relevant services if indicated; those assigned to the control group (n=213) received usual care only. The analyses were by intention to treat. Follow-up data were collected every 4 months for 1 year. FINDINGS: At 12-month follow-up, 77% of both groups remained in the study. The total reported number of falls during this period was 183 in the intervention group compared with 510 in the control group (p=0.0002). The risk of falling was significantly reduced in the intervention group (odds ratio 0.39 [95% CI 0.23-0.66]) as was the risk of recurrent falls (0.33 [0.16-0.68]). In addition, the odds of admission to hospital were lower in the intervention group (0.61 [0.35-1.05]) whereas the decline in Barthel score with time was greater in the control group (p<0.00001). INTERPRETATION: The study shows that an interdisciplinary approach to this high-risk population can significantly decrease the risk of further falls and limit functional impairment.

Primary study

Unclassified

Predictors of falls in a high risk population - results from the prevention of falls in the elderly trial (PROFET)

blocked
Journal Journal of the American Geriatrics Society
Year 2000
Loading references information

Primary study

Unclassified

PROFET Improved clinical outcomes at no additional cost

blocked
Journal Age and ageing
Year 2000
Links ageing.oxfordjournals
Loading references information
INTRODUCTION: The Prevention of Falls in the Elderly Trial (PROFET) is a randomised controlled study of a steructured bidisciplinary assessment of older people attending A & E with a fall. Results have shown a significant reduction in the number of further falls in the intervention group as well as preservation of function. The present study is an economic analysis of PROFET. METHODOLOGY: The cost of the intervention package was estimated by applying national unit costs (Netten & Dennett, 1998) to the staff inputs, and local cost data for the additional hospital tests carried out. Health service costs incurred during the follow-up period were estimated by applying national unit costs to service use data obtained from patient questionnaires and hospital activity data. Analyses were conducted using non-parametric bootstrap methods (Efron, 1993). RESULTS: 147/397 patients were admitted to hospital as a result of their index fall, occupying a mean of 26 bed days at a mean cost of E5793 per admission.

Primary study

Unclassified

Predictors of falls in a high risk population: results from the prevention of falls in the elderly trial (PROFET).

Journal Emergency medicine journal : EMJ
Year 2003
Links Pubmed DOI PubMed Central
Loading references information
OBJECTIVES: The prevention of falls in the elderly trial (PROFET) provides evidence of the benefits of structured interdisciplinary assessment of older people presenting to the accident and emergency department with a fall. However, the service implications of implementing this effective intervention are significant. This study therefore examined risk factors from PROFET and used these to devise a practical approach to streamlining referrals from accident and emergency departments to specialist falls services. METHODS: Logistic regression analysis was used in the control group to identify patients with an increased risk of falling in the absence of any intervention. The derived predictors were investigated to see whether they also predicted loss to follow up. A second regression analysis was undertaken to test for interaction with intervention. RESULTS: Significant positive predictors of further falls were; history of falls in the previous year (OR 1.5 (95%CI 1.1 to 1.9)), falling indoors (OR 2.4 (95%CI 1.1 to 5.2)), and inability to get up after a fall (OR 5.5 (95%CI 2.3 to 13.0)). Negative predictors were moderate alcohol consumption (OR 0.55 (95%CI 0.28 to 1.1)), a reduced abbreviated mental test score (OR 0.7 (95%CI 0.53 to 0.93)), and admission to hospital as a result of the fall (OR 0.26 (95%CI 0.11 to 0.61)). A history of falls (OR 1.2 (95%CI 1.0 to 1.3)), falling indoors (OR 3.2 (95%CI 1.5 to 6.6)) and a reduced abbreviated mental test score (OR 1.3 (95%CI 1.0 to 1.6)) were found to predict loss to follow up. CONCLUSIONS: The study has focused on a readily identifiable high risk group of people presenting at a key interface between the primary and secondary health care sectors. Analysis of derived predictors offers a practical risk based approach to streamlining referrals that is consistent with an attainable level of service commitment.