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

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

• 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.