Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: Systematic review and meta-analysis

Authors: Morello, R.M., Nyman, S.R. et al.

http://eprints.bournemouth.ac.uk/32204/

Journal: Injury Prevention

DOI: 10.1136/injuryprev-2019-043214

Background: Falls are a leading cause of emergency department (ED) presentations in older adults.

Objective: To determine whether multifactorial falls prevention interventions are effective in preventing falls, fall injuries, ED re-presentations and hospital admissions in older adults presenting to the ED with a fall.

Design: Systematic review and meta-analyses of randomised control trials (RCTs). Methods: Four health-related electronic databases were searched (inception to June 2018) with two independent reviewers determining inclusion, assessing study quality and undertaking data extraction. Study selection: RCTs of multifactorial falls prevention interventions targeting community dwelling older adults (≥ 60 years) presenting to the ED with a fall and providing quantitative data on at least one of the review outcomes. Results: Twelve studies involving 3,986 participants, from six countries, were eligible for inclusion. Studies were of variable methodological quality. The multifactorial interventions were heterogeneous, though the majority included components such as education, referral to relevant healthcare services, home modifications, exercise, and medication changes. Meta-analyses demonstrated a non-significant reduction in falls (rate ratio=0.78; 95% CI 0.58, 1.05) with multi-factorial falls prevention programs. Multi-factorial interventions did not significantly affect the number of fallers (risk ratio=1.02; 95% CI 0.88, 1.18), rate of fractured neck of femur (risk ratio=0.82; 95% CI 0.53, 1.25), fall-related ED presentations (rate ratio=0.99; 95% CI 0.84, 1.16), or hospitalisations (rate ratio=1.14; 95% CI 0.69, 1.89). Conclusions: There is insufficient evidence to support the use of multifactorial falls interventions to prevent falls or hospital utilisation in older people presenting to ED following a fall. Further research targeting this population group is required.

This data was imported from PubMed:

Authors: Morello, R.T., Nyman, S.R. et al.

http://eprints.bournemouth.ac.uk/32204/

Journal: Inj Prev

Volume: 25

Issue: 6

Pages: 557-564

eISSN: 1475-5785

DOI: 10.1136/injuryprev-2019-043214

OBJECTIVE: To determine whether multifactorial falls prevention interventions are effective in preventing falls, fall injuries, emergency department (ED) re-presentations and hospital admissions in older adults presenting to the ED with a fall. DESIGN: Systematic review and meta-analyses of randomised controlled trials (RCTs). DATA SOURCES: Four health-related electronic databases (Ovid MEDLINE, CINAHL, EMBASE, PEDro and The Cochrane Central Register of Controlled Trials) were searched (inception to June 2018). STUDY SELECTION: RCTs of multifactorial falls prevention interventions targeting community-dwelling older adults ( ≥ 60 years) presenting to the ED with a fall with quantitative data on at least one review outcome. DATA EXTRACTION: Two independent reviewers determined inclusion, assessed study quality and undertook data extraction, discrepancies resolved by a third. DATA SYNTHESIS: 12 studies involving 3986 participants, from six countries, were eligible for inclusion. Studies were of variable methodological quality. Multifactorial interventions were heterogeneous, though the majority included education, referral to healthcare services, home modifications, exercise and medication changes. Meta-analyses demonstrated no reduction in falls (rate ratio = 0.78; 95% CI: 0.58 to 1.05), number of fallers (risk ratio = 1.02; 95% CI: 0.88 to 1.18), rate of fractured neck of femur (risk ratio = 0.82; 95% CI: 0.53 to 1.25), fall-related ED presentations (rate ratio = 0.99; 95% CI: 0.84 to 1.16) or hospitalisations (rate ratio = 1.14; 95% CI: 0.69 to 1.89) with multifactorial falls prevention programmes. CONCLUSIONS: There is insufficient evidence to support the use of multifactorial interventions to prevent falls or hospital utilisation in older people presenting to ED following a fall. Further research targeting this population group is required.

This data was imported from Scopus:

Authors: Morello, R.T., Nyman, S.R. et al.

http://eprints.bournemouth.ac.uk/32204/

Journal: Injury Prevention

Volume: 25

Issue: 6

Pages: 557-564

eISSN: 1475-5785

ISSN: 1353-8047

DOI: 10.1136/injuryprev-2019-043214

© Author(s) (or their employer(s)) 2019. Objective To determine whether multifactorial falls prevention interventions are effective in preventing falls, fall injuries, emergency department (ED) re-presentations and hospital admissions in older adults presenting to the ED with a fall. Design Systematic review and meta-analyses of randomised controlled trials (RCTs). Data sources Four health-related electronic databases (Ovid MEDLINE, CINAHL, EMBASE, PEDro and The Cochrane Central Register of Controlled Trials) were searched (inception to June 2018). Study selection RCTs of multifactorial falls prevention interventions targeting community-dwelling older adults (≥ 60 years) presenting to the ED with a fall with quantitative data on at least one review outcome. Data extraction Two independent reviewers determined inclusion, assessed study quality and undertook data extraction, discrepancies resolved by a third. Data synthesis 12 studies involving 3986 participants, from six countries, were eligible for inclusion. Studies were of variable methodological quality. Multifactorial interventions were heterogeneous, though the majority included education, referral to healthcare services, home modifications, exercise and medication changes. Meta-analyses demonstrated no reduction in falls (rate ratio = 0.78; 95% CI: 0.58 to 1.05), number of fallers (risk ratio = 1.02; 95% CI: 0.88 to 1.18), rate of fractured neck of femur (risk ratio = 0.82; 95% CI: 0.53 to 1.25), fall-related ED presentations (rate ratio = 0.99; 95% CI: 0.84 to 1.16) or hospitalisations (rate ratio = 1.14; 95% CI: 0.69 to 1.89) with multifactorial falls prevention programmes. Conclusions There is insufficient evidence to support the use of multifactorial interventions to prevent falls or hospital utilisation in older people presenting to ED following a fall. Further research targeting this population group is required.

This data was imported from Web of Science (Lite):

Authors: Morello, R.T., Nyman, S.R. et al.

http://eprints.bournemouth.ac.uk/32204/

Journal: INJURY PREVENTION

Volume: 25

Issue: 6

Pages: 557-564

eISSN: 1475-5785

ISSN: 1353-8047

DOI: 10.1136/injuryprev-2019-043214

The data on this page was last updated at 05:16 on February 19, 2020.