Kristie J Harper1, Annette D Barton1, Glenn Arendts2, Deborah G Edwards1, Antonio C Petta3, Antonio Celenza2. 1. Occupational Therapy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. 2. Emergency Medicine, The University of Western Australia, Perth, Western Australia, Australia. 3. Area Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Abstract
OBJECTIVE: To establish the effectiveness of a brief intervention to prevent falls in older patients presenting to the ED post-discharge. METHODS: The present study is a prospective single-centre, quasi-randomised controlled clinical trial of a brief targeted educational intervention to prevent falls. The intervention group received brief scripted education and were advised of their percentage probability of falling in the next 6 months. The key message was to reinforce the importance of falls prevention strategies and the seriousness of falls. RESULTS: A total of 412 over 65 years old were recruited; 63 (32.1%) patients in the intervention group and 67 (36.8%) in the control group reported falls in the 6 month follow up period (OR 0.81, 95% confidence interval [CI] 0.53-1.25, P = 0.34). No significant differences were noted for mortalities (P = 0.54), ED representations (P = 0.15) and medication changes (P = 0.17). Patients receiving intervention had less hospital admissions (P = 0.002) after adjustment for confounding variables. Intervention patients who presented with a fall had significant (P = 0.007) improvement in function at 6 months, whereas those not presenting with a fall experienced functional decline. CONCLUSION: A brief intervention was associated with maintenance of function in fallers and reduced hospital admissions, without preventing falls post-discharge.
RCT Entities:
OBJECTIVE: To establish the effectiveness of a brief intervention to prevent falls in older patients presenting to the ED post-discharge. METHODS: The present study is a prospective single-centre, quasi-randomised controlled clinical trial of a brief targeted educational intervention to prevent falls. The intervention group received brief scripted education and were advised of their percentage probability of falling in the next 6 months. The key message was to reinforce the importance of falls prevention strategies and the seriousness of falls. RESULTS: A total of 412 over 65 years old were recruited; 63 (32.1%) patients in the intervention group and 67 (36.8%) in the control group reported falls in the 6 month follow up period (OR 0.81, 95% confidence interval [CI] 0.53-1.25, P = 0.34). No significant differences were noted for mortalities (P = 0.54), ED representations (P = 0.15) and medication changes (P = 0.17). Patients receiving intervention had less hospital admissions (P = 0.002) after adjustment for confounding variables. Intervention patients who presented with a fall had significant (P = 0.007) improvement in function at 6 months, whereas those not presenting with a fall experienced functional decline. CONCLUSION: A brief intervention was associated with maintenance of function in fallers and reduced hospital admissions, without preventing falls post-discharge.
Authors: Lauren T Southerland; Julie A Stephens; Christopher R Carpenter; Lorraine C Mion; Susan D Moffatt-Bruce; Angela Zachman; Michael Hill; Jeffrey M Caterino Journal: Implement Sci Commun Date: 2020-02-25
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