Effectiveness of a Falls-and-Fracture Nurse Coordinator to Reduce Falls: A Randomized, Controlled Trial of At-Risk Older Adults
(See editorial comments by Dr. Mary Tinetti on pp 1563–1565)
Article first published online: 2 SEP 2008
© 2008, Copyright the Authors. Journal compilation © 2008, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 56, Issue 8, pages 1383–1389, August 2008
How to Cite
Elley, C. R., Robertson, M. C., Garrett, S., Kerse, N. M., McKinlay, E., Lawton, B., Moriarty, H., Moyes, S. A. and Campbell, A. J. (2008), Effectiveness of a Falls-and-Fracture Nurse Coordinator to Reduce Falls: A Randomized, Controlled Trial of At-Risk Older Adults. Journal of the American Geriatrics Society, 56: 1383–1389. doi: 10.1111/j.1532-5415.2008.01802.x
- Issue published online: 2 SEP 2008
- Article first published online: 2 SEP 2008
- falls prevention;
- elderly people;
- randomized controlled trial;
- multifactorial intervention
OBJECTIVES: To assess the effectiveness of a community-based falls-and-fracture nurse coordinator and multifactorial intervention in reducing falls in older people.
DESIGN: Randomized, controlled trial.
SETTING: Screening for previous falls in family practice followed by community-based intervention.
PARTICIPANTS: Three hundred twelve community-living people aged 75 and older who had fallen in the previous year.
INTERVENTION: Home-based nurse assessment of falls-and-fracture risk factors and home hazards, referral to appropriate community interventions, and strength and balance exercise program. Control group received usual care and social visits.
MEASUREMENTS: Primary outcome was rate of falls over 12 months. Secondary outcomes were muscle strength and balance, falls efficacy, activities of daily living, self-reported physical activity level, and quality of life (Medical Outcomes Study 36-item Short Form Questionnaire).
RESULTS: Of the 3,434 older adults screened for falls, 312 (9%) from 19 family practices were enrolled and randomized. The average age was 81±5, and 69% (215/312) were women. The incidence rate ratio for falls for the intervention group compared with the control group was 0.96 (95% confidence interval=0.70–1.34). There were no significant differences in secondary outcomes between the two groups.
CONCLUSION: This nurse-led intervention was not effective in reducing falls in older people who had fallen previously. Implementation and adherence to the fall-prevention measures was dependent on referral to other health professionals working in their usual clinical practice. This may have limited the effectiveness of the interventions.