Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention—a randomised controlled trial
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...
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| Veröffentlicht in: | Age and ageing 2005-03, Vol.34 (2), p.162-168 |
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| creator | Davison, John Bond, John Dawson, Pamela Steen, I. Nicholas Kenny, Rose Anne |
| description | 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. |
| doi_str_mv | 10.1093/ageing/afi053 |
| format | Article |
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Nicholas ; Kenny, Rose Anne</creator><creatorcontrib>Davison, John ; Bond, John ; Dawson, Pamela ; Steen, I. Nicholas ; Kenny, Rose Anne</creatorcontrib><description>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.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afi053</identifier><identifier>PMID: 15716246</identifier><identifier>CODEN: AANGAH</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Accident & Emergency ; Accident and emergency departments ; Accidental falls ; Accidental Falls - prevention & control ; Aged ; Aged, 80 and over ; Assessment ; Care and treatment ; Causality ; Combined Modality Therapy ; Elderly ; Elderly people ; Emergency Service, Hospital ; fall-related injury ; Falls ; Falls (Accidents) ; Female ; Follow-Up Studies ; Hospitals, General ; Hospitals, University ; Humans ; Injuries ; Interdisciplinary approach ; Male ; Medical treatment ; Mental Status Schedule ; Occupational Therapy ; Older people ; older persons ; Outcome Assessment (Health Care) ; Patient Care Team ; Patient Readmission - statistics & numerical data ; Physical therapy ; Physical therapy for the aged ; Physical Therapy Modalities ; Prevention ; randomised controlled trial ; Randomized controlled trials ; Recurrent ; recurrent falls ; Risk Factors ; Survival Rate ; Therapeutics, Physiological ; treatment ; Wounds and Injuries - prevention & control ; Wounds and Injuries - rehabilitation</subject><ispartof>Age and ageing, 2005-03, Vol.34 (2), p.162-168</ispartof><rights>Copyright Oxford University Press(England) Mar 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-1ceac11c3bd2a2b6c736e93c3b25bc9525d3f02c93163fcb9459e101e3b75e073</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902,30976,30977</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15716246$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Davison, John</creatorcontrib><creatorcontrib>Bond, John</creatorcontrib><creatorcontrib>Dawson, Pamela</creatorcontrib><creatorcontrib>Steen, I. Nicholas</creatorcontrib><creatorcontrib>Kenny, Rose Anne</creatorcontrib><title>Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention—a randomised controlled trial</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><description>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.</description><subject>Accident & Emergency</subject><subject>Accident and emergency departments</subject><subject>Accidental falls</subject><subject>Accidental Falls - prevention & control</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Assessment</subject><subject>Care and treatment</subject><subject>Causality</subject><subject>Combined Modality Therapy</subject><subject>Elderly</subject><subject>Elderly people</subject><subject>Emergency Service, Hospital</subject><subject>fall-related injury</subject><subject>Falls</subject><subject>Falls (Accidents)</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospitals, General</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Injuries</subject><subject>Interdisciplinary approach</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Mental Status Schedule</subject><subject>Occupational Therapy</subject><subject>Older people</subject><subject>older persons</subject><subject>Outcome Assessment (Health Care)</subject><subject>Patient Care Team</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Physical therapy</subject><subject>Physical therapy for the aged</subject><subject>Physical Therapy Modalities</subject><subject>Prevention</subject><subject>randomised controlled trial</subject><subject>Randomized controlled trials</subject><subject>Recurrent</subject><subject>recurrent falls</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>Therapeutics, Physiological</subject><subject>treatment</subject><subject>Wounds and Injuries - prevention & control</subject><subject>Wounds and Injuries - rehabilitation</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkcFu1DAQhi0EokvhyBVZHHoL9dixszkuq8KCKpUDCMTFcpxJcEmc1naA3rjwBjwhT4KjXVHEhZNnNJ9n5p-fkMfAngGrxanp0fn-1HSOSXGHrKBU64KvRXmXrBhjvGAVr4_IgxgvcwoS-H1yBLICxUu1Ij_emOTQp0i_uvSJBrRzCDmnnRmGSE1K6Ns8gG6sde1SOKFnI4Yevb2hDXrsXIbDNNJxHpLrjE1TcGagzicMX_IPN_lf338aGoxvp9FFbKmdfArTMOQwLfBDci_Pi_jo8B6Tdy_O3m53xfnFy1fbzXlhS1WmAiwaC2BF03LDG2UrobAWOeeysbXkshUd47YWoERnm7qUNQIDFE0lkVXimJzs-16F6XrGmHTex-IwGI_THLWqSiEUK_8LLvdTXKgMPv0HvJzm4LMIzaEEUXGADBV7qDcDaucX-fgt2eUCPeoscXuhNyAYh7WSf_E2TDEG7PRVcKMJNxqYXlzXe9f13vXMPzksMTcjtrf0webbhi7mwX_qJnzOkkUl9e7DR_38PYidep0D8RtLobuf</recordid><startdate>200503</startdate><enddate>200503</enddate><creator>Davison, John</creator><creator>Bond, John</creator><creator>Dawson, Pamela</creator><creator>Steen, I. Nicholas</creator><creator>Kenny, Rose Anne</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>200503</creationdate><title>Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention—a randomised controlled trial</title><author>Davison, John ; Bond, John ; Dawson, Pamela ; Steen, I. Nicholas ; Kenny, Rose Anne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-1ceac11c3bd2a2b6c736e93c3b25bc9525d3f02c93163fcb9459e101e3b75e073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Accident & Emergency</topic><topic>Accident and emergency departments</topic><topic>Accidental falls</topic><topic>Accidental Falls - prevention & control</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Assessment</topic><topic>Care and treatment</topic><topic>Causality</topic><topic>Combined Modality Therapy</topic><topic>Elderly</topic><topic>Elderly people</topic><topic>Emergency Service, Hospital</topic><topic>fall-related injury</topic><topic>Falls</topic><topic>Falls (Accidents)</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospitals, General</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Injuries</topic><topic>Interdisciplinary approach</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Mental Status Schedule</topic><topic>Occupational Therapy</topic><topic>Older people</topic><topic>older persons</topic><topic>Outcome Assessment (Health Care)</topic><topic>Patient Care Team</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Physical therapy</topic><topic>Physical therapy for the aged</topic><topic>Physical Therapy Modalities</topic><topic>Prevention</topic><topic>randomised controlled trial</topic><topic>Randomized controlled trials</topic><topic>Recurrent</topic><topic>recurrent falls</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>Therapeutics, Physiological</topic><topic>treatment</topic><topic>Wounds and Injuries - prevention & control</topic><topic>Wounds and Injuries - rehabilitation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Davison, John</creatorcontrib><creatorcontrib>Bond, John</creatorcontrib><creatorcontrib>Dawson, Pamela</creatorcontrib><creatorcontrib>Steen, I. Nicholas</creatorcontrib><creatorcontrib>Kenny, Rose Anne</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Davison, John</au><au>Bond, John</au><au>Dawson, Pamela</au><au>Steen, I. Nicholas</au><au>Kenny, Rose Anne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention—a randomised controlled trial</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2005-03</date><risdate>2005</risdate><volume>34</volume><issue>2</issue><spage>162</spage><epage>168</epage><pages>162-168</pages><issn>0002-0729</issn><eissn>1468-2834</eissn><coden>AANGAH</coden><abstract>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.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>15716246</pmid><doi>10.1093/ageing/afi053</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Age and ageing, 2005-03, Vol.34 (2), p.162-168 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Accident & Emergency Accident and emergency departments Accidental falls Accidental Falls - prevention & control Aged Aged, 80 and over Assessment Care and treatment Causality Combined Modality Therapy Elderly Elderly people Emergency Service, Hospital fall-related injury Falls Falls (Accidents) Female Follow-Up Studies Hospitals, General Hospitals, University Humans Injuries Interdisciplinary approach Male Medical treatment Mental Status Schedule Occupational Therapy Older people older persons Outcome Assessment (Health Care) Patient Care Team Patient Readmission - statistics & numerical data Physical therapy Physical therapy for the aged Physical Therapy Modalities Prevention randomised controlled trial Randomized controlled trials Recurrent recurrent falls Risk Factors Survival Rate Therapeutics, Physiological treatment Wounds and Injuries - prevention & control Wounds and Injuries - rehabilitation |
| title | Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention—a randomised controlled trial |
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