Fall prevention programmes for older people in primary, community and emergency care settings may be ineffective, according to researchers at the University of Warwick’s Medical School
Falls are a major health problem for older adults, through both immediate effects such as fractures and head injuries and longer term problems such as disability, fear of falling and loss of independence.
In a study published in this week’s British Medical Journal (December 18, 2007), Dr Simon Gates and Professor Sallie Lamb from Warwick Medical School led a review of 19 trials from eight countries, including 6,397 participants, to evaluate the effectiveness of risk assessment and intervention programmes to prevent falls and injuries. These programmes assess people’s individual risk factors for falling and provide targeted treatments to reduce them such as training in strength and balance, modification of hazards at home and the withdrawal of psychotropic drugs.
The research team found no clear reduction in the number of people suffering at least one fall, the number having fall-related injuries, or the use of health services. The team noted that current evidence suggests risk assessment may reduce the number of fallers by a small amount and evidence of its effects on other outcomes such as the rate of falls and injuries was insufficient.
They concluded higher intensity interventions that provide treatments to address risk factors rather than information and referral may be more effective. There is a need for further large, high quality studies to resolve the question of whether this type of intervention is effective.
The study, Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis, can be found at: http://www.bmj.com/cgi/content/full/bmj.39412.525243.BEv1
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