Literature DB >> 18266663

Effectiveness of falls clinics: an evaluation of outcomes and client adherence to recommended interventions.

Keith D Hill1, Kirsten J Moore, Michael I Dorevitch, Lesley M Day.   

Abstract

OBJECTIVES: To evaluate outcomes associated with falls clinic programs.
DESIGN: Longitudinal.
SETTING: Thirteen outpatient falls clinics in Victoria, Australia. PARTICIPANTS: Four hundred fifty-four people referred for clinic assessment (mean age+/-standard deviation 77.9+/-8.8; 73% female). INTERVENTION: After assessment, multifactorial interventions were organized to address identified risk factors. MEASUREMENTS: A Minimum Data Set was developed and used across all clinics to derive common data on falls, falls injuries, and secondary measures associated with falls risk, including balance, falls efficacy, gait, leg strength, function, and activity. All measures were repeated 6 months later.
RESULTS: Clients had a high risk of falls, with 78% having had falls in the preceding 6 months (63% multiple fallers, 10% experiencing fractures from the falls). An average of 7.6+/-2.8 falls risk factors were identified per client. The clinic team organized an average of 5.7+/-2.3 new or additional interventions per client. Sixty-one percent of eligible clients returned for the 6-month assessment. At this time, there was more than a 50% reduction in falls, multiple falls, and fall injuries (P < or = .004) and small but significant improvements evident on secondary measures of balance, leg strength, gait speed, and confidence outcomes (P < .006). Average adherence to recommendations was 74.3%. Factors associated with higher adherence included being male, younger than 65, living with others, and having a caregiver (P < .05).
CONCLUSION: This large multicenter study identified high falls risk of older people referred to falls clinics, the multifactorial nature of their presenting problems and provides preliminary evidence of positive outcomes after falls clinic management.

Entities:  

Mesh:

Year:  2008        PMID: 18266663     DOI: 10.1111/j.1532-5415.2007.01626.x

Source DB:  PubMed          Journal:  J Am Geriatr Soc        ISSN: 0002-8614            Impact factor:   5.562


  17 in total

Review 1.  [Polypharmacy and falls in the Elderly].

Authors:  Ulrike Sommeregger; Bernhard Iglseder; Birgit Böhmdorfer; Ursula Benvenuti-Falger; Peter Dovjak; Monika Lechleitner; Ronald Otto; Regina E Roller; Markus Gosch
Journal:  Wien Med Wochenschr       Date:  2010-06

2.  Translating a multifactorial fall prevention intervention into practice: a controlled evaluation of a fall prevention clinic.

Authors:  Meghann Moore; Barbara Williams; Sally Ragsdale; James P Logerfo; J Richard Goss; Astrid B Schreuder; Elizabeth A Phelan
Journal:  J Am Geriatr Soc       Date:  2010-02       Impact factor: 5.562

3.  Hypnosedative use and predictors of successful withdrawal in new patients attending a falls clinic: a retrospective, cohort study.

Authors:  Jenna Joester; Constance M Vogler; Kevin Chang; Sarah N Hilmer
Journal:  Drugs Aging       Date:  2010-11-01       Impact factor: 3.923

4.  Prediction of future falls in a community dwelling older adult population using instrumented balance and gait analysis.

Authors:  C M Bauer; I Gröger; R Rupprecht; V L Marcar; K G Gaßmann
Journal:  Z Gerontol Geriatr       Date:  2015-04-11       Impact factor: 1.281

Review 5.  Physical therapy approaches to reduce fall and fracture risk among older adults.

Authors:  Saija Karinkanta; Maarit Piirtola; Harri Sievänen; Kirsti Uusi-Rasi; Pekka Kannus
Journal:  Nat Rev Endocrinol       Date:  2010-06-01       Impact factor: 43.330

6.  Evaluation of the Frails' Fall Efficacy by Comparing Treatments (EFFECT) on reducing fall and fear of fall in moderately frail older adults: study protocol for a randomised control trial.

Authors:  Boon Chong Kwok; Kaysar Mamun; Manju Chandran; Chek Hooi Wong
Journal:  Trials       Date:  2011-06-18       Impact factor: 2.279

7.  Predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people.

Authors:  Martin J Spink; Mohammad R Fotoohabadi; Elin Wee; Karl B Landorf; Keith D Hill; Stephen R Lord; Hylton B Menz
Journal:  BMC Geriatr       Date:  2011-08-26       Impact factor: 3.921

Review 8.  Differing approaches to falls and fracture prevention between Australia and Colombia.

Authors:  Fernando Gomez; Carmen Lucia Curcio; Pushpa Suriyaarachchi; Oddom Demontiero; Gustavo Duque
Journal:  Clin Interv Aging       Date:  2013-01-20       Impact factor: 4.458

9.  Tailored education for older patients to facilitate engagement in falls prevention strategies after hospital discharge--a pilot randomized controlled trial.

Authors:  Anne-Marie Hill; Christopher Etherton-Beer; Terry P Haines
Journal:  PLoS One       Date:  2013-05-23       Impact factor: 3.240

10.  Don't lose sight of the importance of the individual in effective falls prevention interventions.

Authors:  Keith Hill
Journal:  BMC Geriatr       Date:  2009-04-22       Impact factor: 3.921

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