A L Barker1, P A Cameron1, K D Hill2, L Flicker3, T P Haines4, J A Lowthian1, N Waldron5, G Arendts6, J Redfern7, A Forbes8, C A Brand9, C D Etherton-Beer3, A M Hill10, P Hunter11, S R Nyman12, D Smit11. 1. Health Services Research Unit, Centre of Research Excellence in Patient Safety, Division of Health Services and Global Health Research, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 2. School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia, Australia. 3. University of Western Australia, Perth, Western Australia, Australia Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia Harry Perkins Institute for Medical Research, Perth, Western Australia, Australia. 4. Department of Physiotherapy, Monash University, and Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia. 5. Health Networks Branch, System Policy and Planning, Department of Health, Government of Western Australia, Perth, Western Australia, Australia. 6. University of Western Australia, Perth, Western Australia, Australia Harry Perkins Institute for Medical Research, Perth, Western Australia, Australia. 7. The George Institute for Global Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia. 8. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 9. Health Services Research Unit, Centre of Research Excellence in Patient Safety, Division of Health Services and Global Health Research, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia. 10. School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia. 11. Alfred Health, Melbourne, Victoria, Australia. 12. Bournemouth University Dementia Institute and Psychology Department, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK.
Abstract
INTRODUCTION: Participation in falls prevention activities by older people following presentation to the emergency department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND programme, an intervention designed to improve older persons' participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies. DESIGN AND SETTING: A RCT at two tertiary referral EDs in Melbourne and Perth, Australia. PARTICIPANTS: 528 community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who require an interpreter or hands-on assistance to walk; live in residential aged care or >50 km from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or a history of psychosis; are receiving palliative care or are unable to use a telephone will be excluded. METHODS: Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates (1) a home-based risk factor assessment; (2) education, coaching, goal setting and follow-up telephone support for management of one or more of four risk factors with evidence of effective interventions and (3) healthcare provider communication and community linkage delivered over 6 months. Primary outcomes are falls and fall injuries per person-year. DISCUSSION: RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease; however, evidence to support this approach in falls prevention is limited. TRIAL REGISTRATION NUMBER: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
RCT Entities:
INTRODUCTION: Participation in falls prevention activities by older people following presentation to the emergency department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND programme, an intervention designed to improve older persons' participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies. DESIGN AND SETTING: A RCT at two tertiary referral EDs in Melbourne and Perth, Australia. PARTICIPANTS: 528 community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who require an interpreter or hands-on assistance to walk; live in residential aged care or >50 km from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or a history of psychosis; are receiving palliative care or are unable to use a telephone will be excluded. METHODS:Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates (1) a home-based risk factor assessment; (2) education, coaching, goal setting and follow-up telephone support for management of one or more of four risk factors with evidence of effective interventions and (3) healthcare provider communication and community linkage delivered over 6 months. Primary outcomes are falls and fall injuries per person-year. DISCUSSION: RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease; however, evidence to support this approach in falls prevention is limited. TRIAL REGISTRATION NUMBER: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Anna Barker; Peter Cameron; Leon Flicker; Glenn Arendts; Caroline Brand; Christopher Etherton-Beer; Andrew Forbes; Terry Haines; Anne-Marie Hill; Peter Hunter; Judy Lowthian; Samuel R Nyman; Julie Redfern; De Villiers Smit; Nicholas Waldron; Eileen Boyle; Ellen MacDonald; Darshini Ayton; Renata Morello; Keith Hill Journal: PLoS Med Date: 2019-05-24 Impact factor: 11.069
Authors: Rebecca L Morris; Keith D Hill; Ilana N Ackerman; Darshini Ayton; Glenn Arendts; Caroline Brand; Peter Cameron; Christopher D Etherton-Beer; Leon Flicker; Anne-Marie Hill; Peter Hunter; Judy A Lowthian; Renata Morello; Samuel R Nyman; Julie Redfern; De Villiers Smit; Anna L Barker Journal: BMC Health Serv Res Date: 2019-11-28 Impact factor: 2.655
Authors: Rebecca L Morris; Sze-Ee Soh; Keith D Hill; Rachelle Buchbinder; Judy A Lowthian; Julie Redfern; Christopher D Etherton-Beer; Anne-Marie Hill; Richard H Osborne; Glenn Arendts; Anna L Barker Journal: BMC Health Serv Res Date: 2017-08-29 Impact factor: 2.655