Journal article
A multidisciplinary intervention to prevent subsequent falls and health service use following fall-related paramedic care: a randomised controlled trial
Age and Ageing, Vol.46(2), pp.200-207
2017
Abstract
Background approximately 25% of older people who fall and receive paramedic care are not subsequently transported to an emergency department (ED). These people are at high risk of future falls, unplanned healthcare use and poor health outcomes. Objective to evaluate the impact of a fall-risk assessment and tailored fall prevention interventions among older community-dwellers not transported to ED following a fall on subsequent falls and health service use. Design, setting, participants Randomised controlled trial involving 221 non-transported older fallers from Sydney, Australia. Intervention the intervention targeted identified risk factors and used existing services to implement physiotherapy, occupational therapy, geriatric assessment, optometry and medication management interventions as appropriate. The control group received individualised written fall prevention advice. Measurements primary outcome measures were rates of falls and injurious falls. Secondary outcome measures were ambulance re-attendance, ED presentation, hospitalisation and quality of life over 12 months. Analysis was by intention-to-treat and per-protocol according to self-reported adherence using negative binominal regression and multivariate analysis. Results ITT analysis showed no significant difference between groups in subsequent falls, injurious falls and health service use. The per-protocol analyses revealed that the intervention participants who adhered to the recommended interventions had significantly lower rates of falls compared to non-adherers (IRR: 0.53 (95% CI : 0.32-0.87)). Conclusion a multidisciplinary intervention did not prevent falls in older people who received paramedic care but were not transported to ED. However the intervention was effective in those who adhered to the recommendations.
Details
- Title
- A multidisciplinary intervention to prevent subsequent falls and health service use following fall-related paramedic care: a randomised controlled trial
- Authors
- A Stefanie Mikolaizak (Author) - Neuroscience Research AustraliaStephen R Lord (Author) - Neuroscience Research AustraliaAnne Tiedemann (Author) - George Institute for Global HealthPaul Simpson (Author) - Western Sydney UniversityGideon A Caplan (Author) - Prince of Wales HospitalJason Bendall (Author) - University of the Sunshine Coast - Faculty of Science, Health, Education and EngineeringKirsten Howard (Author) - University of SydneyLyndell Webster (Author) - Neuroscience Research AustraliaNarelle Payne (Author) - Neuroscience Research AustraliaSarah Hamilton (Author) - Neuroscience Research AustraliaJoanne Lo (Author) - Neuroscience Research AustraliaElisabeth Ramsay (Author) - George Institute for Global HealthSandra O'Rouke (Author) - Neuroscience Research AustraliaLinda Roylance (Author) - Neuroscience Research AustraliaJ C Close (Author) - Neuroscience Research Australia
- Publication details
- Age and Ageing, Vol.46(2), pp.200-207
- Publisher
- Oxford University Press
- Date published
- 2017
- DOI
- 10.1093/ageing/afw190
- ISSN
- 0002-0729
- Organisation Unit
- University of the Sunshine Coast, Queensland
- Language
- English
- Record Identifier
- 99450548502621
- Output Type
- Journal article
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- Domestic collaboration
- Web Of Science research areas
- Geriatrics & Gerontology
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