A Stefanie Mikolaizak1, Stephen R Lord1, Anne Tiedemann2, Paul Simpson3, Gideon Caplan4,5, Jason C Bendall6,7, Kirsten Howard8, Jacqueline Close1,4. 1. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia. 2. The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia. 3. School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia. 4. Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia. 5. Prince of Wales Hospital, Sydney, New South Wales, Australia. 6. School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia. 7. Ambulance Service of New South Wales, Sydney, New South Wales, Australia. 8. School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Abstract
OBJECTIVE: To identify predictors and impact of adherence to a multifactorial fall-prevention program on falls and health service utilisation. METHODS: Randomised controlled trial with a priori subgroup analysis within intervention group according to adherence. Participants were community dwelling, (≥65 years), not transported to hospital following fall-related paramedic care. The Attitudes to Falls-Related Interventions Scale (AFRIS) was completed at baseline, adherence levels were measured (three-point scale) at six months, and falls and health service utilisation were recorded for 12 months. Multivariate logistic regression and area under the curve were calculated with 95% confidence interval (CI). RESULTS:Attitudes to Falls-Related Interventions Scale scores (n = 85) were independent of baseline characteristics. At six months, 39 (46%) participants reported full adherence. Independent predictors of adherence were positive AFRIS (OR 4.10, 95% CI 1.48-11.39) and receiving 3+ recommendations (OR 3.36, 95% CI 1.26-9.00). Adherers experienced fewer falls (IRR 0.53, 95% CI 0.45-0.80) and fall-related health service use (emergency department presentations IRR 0.37, 95% CI 0.17-0.82) compared to non-adherers. CONCLUSION:Older adults who adhere to recommendations benefit, regardless of fall-risk profile.
RCT Entities:
OBJECTIVE: To identify predictors and impact of adherence to a multifactorial fall-prevention program on falls and health service utilisation. METHODS: Randomised controlled trial with a priori subgroup analysis within intervention group according to adherence. Participants were community dwelling, (≥65 years), not transported to hospital following fall-related paramedic care. The Attitudes to Falls-Related Interventions Scale (AFRIS) was completed at baseline, adherence levels were measured (three-point scale) at six months, and falls and health service utilisation were recorded for 12 months. Multivariate logistic regression and area under the curve were calculated with 95% confidence interval (CI). RESULTS: Attitudes to Falls-Related Interventions Scale scores (n = 85) were independent of baseline characteristics. At six months, 39 (46%) participants reported full adherence. Independent predictors of adherence were positive AFRIS (OR 4.10, 95% CI 1.48-11.39) and receiving 3+ recommendations (OR 3.36, 95% CI 1.26-9.00). Adherers experienced fewer falls (IRR 0.53, 95% CI 0.45-0.80) and fall-related health service use (emergency department presentations IRR 0.37, 95% CI 0.17-0.82) compared to non-adherers. CONCLUSION: Older adults who adhere to recommendations benefit, regardless of fall-risk profile.
Authors: Nada Hammouda; Christopher R Carpenter; William W Hung; Adriane Lesser; Sylviah Nyamu; Shan Liu; Cameron J Gettel; Aaron Malsch; Edward M Castillo; Savannah Forrester; Kimberly Souffront; Samuel Vargas; Elizabeth M Goldberg Journal: Acad Emerg Med Date: 2021-06-15 Impact factor: 3.451
Authors: Kristin Taraldsen; A Stefanie Mikolaizak; Andrea B Maier; Elisabeth Boulton; Kamiar Aminian; Jeanine van Ancum; Stefania Bandinelli; Clemens Becker; Ronny Bergquist; Lorenzo Chiari; Lindy Clemson; David P French; Brenda Gannon; Helen Hawley-Hague; Nini H Jonkman; Sabato Mellone; Anisoara Paraschiv-Ionescu; Mirjam Pijnappels; Michael Schwenk; Chris Todd; Fan Bella Yang; Anna Zacchi; Jorunn L Helbostad; Beatrix Vereijken Journal: BMJ Open Date: 2019-03-20 Impact factor: 2.692
Authors: A Stefanie Mikolaizak; Kristin Taraldsen; Elisabeth Boulton; Katharina Gordt; Andrea Britta Maier; Sabato Mellone; Helen Hawley-Hague; Kamiar Aminian; Lorenzo Chiari; Anisoara Paraschiv-Ionescu; Mirjam Pijnappels; Chris Todd; Beatrix Vereijken; Jorunn L Helbostad; Clemens Becker Journal: BMJ Open Date: 2022-10-05 Impact factor: 3.006