Parts of the results described in this paper were presented at the 59th Annual Meeting of the Gerontological Society of America, Dallas, Texas, November 2006. The symposium presentation was entitled: “Effects of a multidisciplinary fall prevention program among community-dwelling elderly people: implications for practice.”
Lack of Effectiveness of a Multidisciplinary Fall-Prevention Program in Elderly People at Risk: A Randomized, Controlled Trial
Article first published online: 24 JUL 2008
© 2008, Copyright the Authors. Journal compilation © 2008, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 56, Issue 8, pages 1390–1397, August 2008
How to Cite
Hendriks, M. R. C., Bleijlevens, M. H. C., Van Haastregt, J. C. M., Crebolder, H. F. J. M., Diederiks, J. P. M., Evers, S. M. A. A., Mulder, W. J., Kempen, G. I. J. M., Van Rossum, E., Ruijgrok, J. M., Stalenhoef, P. A. and Van Eijk, J. Th. M. (2008), Lack of Effectiveness of a Multidisciplinary Fall-Prevention Program in Elderly People at Risk: A Randomized, Controlled Trial. Journal of the American Geriatrics Society, 56: 1390–1397. doi: 10.1111/j.1532-5415.2008.01803.x
[See editorial comments by Dr. Mary Tinetti on pp 1563–1565]
- Issue published online: 2 SEP 2008
- Article first published online: 24 JUL 2008
- accidental falls;
- intervention studies
OBJECTIVES: To assess whether a pragmatic multidisciplinary fall-prevention program was more effective than usual care in preventing new falls and functional decline in elderly people.
DESIGN: A two-group, randomized, controlled trial with 12 months of follow-up.
SETTING: University hospital and home-based intervention, the Netherlands.
PARTICIPANTS: Three hundred thirty-three community-dwelling Dutch people aged 65 and over who were seen in an emergency department after a fall.
INTERVENTION: Participants in the intervention group underwent a detailed medical and occupational-therapy assessment to evaluate and address risk factors for recurrent falls, followed by recommendations and referral if indicated. People in the control group received usual care.
MEASUREMENTS: Number of people sustaining a fall (fall calendar) and daily functioning (Frenchay Activity Index).
RESULTS: Results showed no statistically significantly favorable effects on falls (odds ratio=0.86, 95% confidence interval (CI)=0.50–1.49) or daily functioning (regression coefficient=0.37, CI=−0.90 to 1.63) after 12 months of follow-up.
CONCLUSION: The multidisciplinary fall-prevention program was not effective in preventing falls and functional decline in this Dutch healthcare setting. Implementing the program in its present form in the Netherlands is not recommended. This trial shows that there can be considerable discrepancy between the “ideal” (experimental) version of a program and the implemented version of the same program. The importance of implementation research in assessing feasibility and effectiveness of such a program in a specific healthcare setting is therefore stressed.