UNLABELLED: OBJECTIVE To study the potential differences in patient characteristics between two referral methods to a fall clinic, specifically: case-finding of patients admitted to an emergency department because of a fall, compared to direct referral to the fall clinic via the general practitioner. DESIGN: Cross-sectional study. SETTING: Fall clinics in two university teaching hospitals in the Netherlands. PARTICIPANTS: Three hundred community-dwelling older people aged 65 years or over currently attending the fall clinics in Nijmegen (Group 1, n=154) and in Amsterdam (Group 2, n=146). MEASUREMENTS: Patients were referred by a general practitioner (Group 1) or were selected using the Carefall Triage Instrument (CTI) after visiting the emergency department (Group 2). In all patients, modifiable risk factors for recurrent falls were assessed. RESULTS: Group 1 had less modifiable risk factors for falling (a mean of 4 (SD 1.6) vs. a mean of 5 (SD 1.5) in Group 2, p < 0.001). Compared to Group 2, Group 1 had more prevalent " recurrent falling (≥ 2 falls)" (p=0.001) and "assisted living in homes for the aged" (p=0.037). "Fear of falling", "mobility and balance problems", "home hazards" and "osteoporosis" were significantly less prevalent in Group 1. CONCLUSION: This study suggests that patients referred to a multidisciplinary fall prevention clinic by their general practitioner have a different risk profile than those selected by case finding using the CTI. These differences have consequences for the reach of secondary care for fall-preventive interventions and will probably influence the effectiveness and efficiency of a fall prevention program.
UNLABELLED: OBJECTIVE To study the potential differences in patient characteristics between two referral methods to a fall clinic, specifically: case-finding of patients admitted to an emergency department because of a fall, compared to direct referral to the fall clinic via the general practitioner. DESIGN: Cross-sectional study. SETTING: Fall clinics in two university teaching hospitals in the Netherlands. PARTICIPANTS: Three hundred community-dwelling older people aged 65 years or over currently attending the fall clinics in Nijmegen (Group 1, n=154) and in Amsterdam (Group 2, n=146). MEASUREMENTS: Patients were referred by a general practitioner (Group 1) or were selected using the Carefall Triage Instrument (CTI) after visiting the emergency department (Group 2). In all patients, modifiable risk factors for recurrent falls were assessed. RESULTS: Group 1 had less modifiable risk factors for falling (a mean of 4 (SD 1.6) vs. a mean of 5 (SD 1.5) in Group 2, p < 0.001). Compared to Group 2, Group 1 had more prevalent " recurrent falling (≥ 2 falls)" (p=0.001) and "assisted living in homes for the aged" (p=0.037). "Fear of falling", "mobility and balance problems", "home hazards" and "osteoporosis" were significantly less prevalent in Group 1. CONCLUSION: This study suggests that patients referred to a multidisciplinary fall prevention clinic by their general practitioner have a different risk profile than those selected by case finding using the CTI. These differences have consequences for the reach of secondary care for fall-preventive interventions and will probably influence the effectiveness and efficiency of a fall prevention program.
Authors: D B Hogan; F A MacDonald; J Betts; S Bricker; E M Ebly; B Delarue; T S Fung; C Harbidge; M Hunter; C J Maxwell; B Metcalf Journal: CMAJ Date: 2001-09-04 Impact factor: 8.262
Authors: M E Tinetti; D I Baker; G McAvay; E B Claus; P Garrett; M Gottschalk; M L Koch; K Trainor; R I Horwitz Journal: N Engl J Med Date: 1994-09-29 Impact factor: 91.245
Authors: C Raina Elley; M Clare Robertson; Ngaire M Kerse; Sue Garrett; Eileen McKinlay; Beverley Lawton; Helen Moriarty; A John Campbell Journal: BMC Public Health Date: 2007-07-29 Impact factor: 3.295
Authors: Sarah E Lamb; Joanne D Fisher; Simon Gates; Rachel Potter; Matthew W Cooke; Yvonne H Carter Journal: BMC Health Serv Res Date: 2008-11-12 Impact factor: 2.655