UNLABELLED: To assess the effectiveness of an environmental falls prevention intervention delivered by qualified occupational therapists or unqualified trained assessors. DESIGN: A pilot three-armed randomized controlled trial. SETTING: Airedale National Health Service Trust catchment, North and West Yorkshire, England. PARTICIPANTS: Two hundred thirty-eight community-dwelling adults aged 70 and older with a history of falls in the previous year. INTERVENTION: Assessment and modification of the home environment of people at greater risk of falls. MEASUREMENTS: Fear of falling was the primary outcome measure, and an analysis of covariance was conducted on the area under the curve at 12 months. As a secondary outcome, falls were analysed using negative binomial regression. Quality of life and independence in activities of daily living (ADLs) were also measured. RESULTS: The intervention had no effect on fear of falling (P=.63). The occupational therapy group had significantly fewer falls than controls 12 months after the assessment (incidence rate ratio (IRR)=0.54, 95% confidence interval (CI)=0.36-0.83, P=.005). There was no significant effect on falls in the trained assessor group (IRR=0.78, 95% CI=0.51-1.21, P=.34). CONCLUSION: Environmental assessment had no effect on fear of falling. Environmental assessment prescribed by an occupational therapist significantly reduced the number of falls in high-risk individuals whereas that prescribed by a trained assessor did not. Further research in other settings is needed to confirm this, to explore the mechanisms, and to estimate cost-effectiveness.
RCT Entities:
UNLABELLED: To assess the effectiveness of an environmental falls prevention intervention delivered by qualified occupational therapists or unqualified trained assessors. DESIGN: A pilot three-armed randomized controlled trial. SETTING: Airedale National Health Service Trust catchment, North and West Yorkshire, England. PARTICIPANTS: Two hundred thirty-eight community-dwelling adults aged 70 and older with a history of falls in the previous year. INTERVENTION: Assessment and modification of the home environment of people at greater risk of falls. MEASUREMENTS: Fear of falling was the primary outcome measure, and an analysis of covariance was conducted on the area under the curve at 12 months. As a secondary outcome, falls were analysed using negative binomial regression. Quality of life and independence in activities of daily living (ADLs) were also measured. RESULTS: The intervention had no effect on fear of falling (P=.63). The occupational therapy group had significantly fewer falls than controls 12 months after the assessment (incidence rate ratio (IRR)=0.54, 95% confidence interval (CI)=0.36-0.83, P=.005). There was no significant effect on falls in the trained assessor group (IRR=0.78, 95% CI=0.51-1.21, P=.34). CONCLUSION: Environmental assessment had no effect on fear of falling. Environmental assessment prescribed by an occupational therapist significantly reduced the number of falls in high-risk individuals whereas that prescribed by a trained assessor did not. Further research in other settings is needed to confirm this, to explore the mechanisms, and to estimate cost-effectiveness.
Authors: Susan Stark; Emily Somerville; Jane Conte; Marian Keglovits; Yi-Ling Hu; Christopher Carpenter; Holly Hollingsworth; Yan Yan Journal: Am J Occup Ther Date: 2018 Jan/Feb
Authors: Julie Bruce; Anower Hossain; Ranjit Lall; Emma J Withers; Susanne Finnegan; Martin Underwood; Chen Ji; Chris Bojke; Roberta Longo; Claire Hulme; Susie Hennings; Ray Sheridan; Katharine Westacott; Shvaita Ralhan; Finbarr Martin; John Davison; Fiona Shaw; Dawn A Skelton; Jonathan Treml; Keith Willett; Sarah E Lamb Journal: Health Technol Assess Date: 2021-05 Impact factor: 4.014
Authors: Lesley D Gillespie; M Clare Robertson; William J Gillespie; Catherine Sherrington; Simon Gates; Lindy M Clemson; Sarah E Lamb Journal: Cochrane Database Syst Rev Date: 2012-09-12
Authors: Toby O Smith; Paul Jepson; Andrew Beswick; Gina Sands; Avril Drummond; Edward T Davis; Catherine M Sackley Journal: Cochrane Database Syst Rev Date: 2016-07-04