Literature DB >> 19221130

A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT).

Jacques C L Neyens1, Béatrice P J Dijcks, Jos Twisk, Jos M G A Schols, Jolanda C M van Haastregt, Wim J A van den Heuvel, Luc P de Witte.   

Abstract

OBJECTIVE: to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients.
DESIGN: cluster-randomised controlled 12-month trial.
SETTING: psychogeriatric wards in 12 nursing homes in The Netherlands. PARTICIPANTS: psychogeriatric nursing home patients (n = 518). INTERVENTION: a general medical assessment and an additional specific fall risk evaluation tool, applied by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities. MEASUREMENTS: falls.
RESULTS: there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward-related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43-0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme.
CONCLUSION: the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduces the number of falls. This reduction is substantial and of high clinical relevance.

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Year:  2009        PMID: 19221130     DOI: 10.1093/ageing/afn297

Source DB:  PubMed          Journal:  Age Ageing        ISSN: 0002-0729            Impact factor:   10.668


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