A Randomized Controlled Trial of a Multifactorial Falls Prevention Intervention for Older Fallers Presenting to Emergency Departments

• Autores: Melissa A. Russell, Keith D. Hill, Lesley M. Day, Irene Blackberry, Jenny Schwartz, Melita J. Giummarra, Michael Dorevitch, Joseph E. Ibrahim, Andrew C. Dalton, Shyamali Dharmage
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 58, Nº. 12, 2010, págs. 2265-2274
• Idioma: inglés
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• Resumen

  • OBJECTIVES: To investigate the effect of a referral-based targeted multifactorial falls prevention intervention on the occurrence of recurrent falls and injuries in older people presenting to an emergency department (ED) after a fall and discharged directly home from the ED.

    DESIGN: Randomized controlled trial. Assessors of outcomes were unaware of group allocation.

    SETTING: Seven EDs in metropolitan Melbourne, Australia.

    PARTICIPANTS: Inclusion criteria were community dwelling, aged 60 and older, presenting to an ED after a fall, and discharged directly home. Exclusion criteria were unable to follow simple instructions or walk independently.

    INTERVENTION: Targeted referrals to existing community services and health promotion recommendations, based on the falls risk factors found in a baseline assessment.

    MEASUREMENTS: Primary outcome measures were falls and resultant injuries occurring over the 12-month follow-up period. Falls and injury data were collected using falls calendars supported by medical record reviews.

    RESULTS: Three hundred sixty-one participants were randomized to the standard care group and 351 to the intervention group. No significant difference was found between the two groups over the 12-month follow-up period in number of fallers (relative risk (RR)=1.11, 95% confidence interval (CI)=0.95�1.31] or number of participants sustaining an injury from a fall (RR=1.06, 95% CI=0.86�1.29).

    CONCLUSION: This study does not support the use of a referral-based targeted multifactorial intervention program to reduce subsequent falls or fall injuries in older people who present to an ED after a fall.