Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education

Background: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in...

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Main Authors: Hill, Anne-Marie, McPhail, S.M., Haines, T.P., Morris, M.E., Etherton-Beer, C., Shorr, R., Flicker, L., Bulsara, M., Waldron, N., Lee, D.C.A., Francis-Coad, J., Boudville, A., Newman, A.
Format: Journal Article
Language:English
Published: OXFORD UNIV PRESS INC 2019
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/85219
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author Hill, Anne-Marie
McPhail, S.M.
Haines, T.P.
Morris, M.E.
Etherton-Beer, C.
Shorr, R.
Flicker, L.
Bulsara, M.
Waldron, N.
Lee, D.C.A.
Francis-Coad, J.
Boudville, A.
Newman, A.
author_facet Hill, Anne-Marie
McPhail, S.M.
Haines, T.P.
Morris, M.E.
Etherton-Beer, C.
Shorr, R.
Flicker, L.
Bulsara, M.
Waldron, N.
Lee, D.C.A.
Francis-Coad, J.
Boudville, A.
Newman, A.
author_sort Hill, Anne-Marie
building Curtin Institutional Repository
collection Online Access
description Background: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. Methods: A randomized clinical trial at three hospitals in Western Australia: Participants followed for 6 months after discharge. Baseline and outcomes measured by assessors masked to group allocation. Participants: Aged 60 years and over, admitted for rehabilitation. Eligibility included: Cognitively able to undertake education (Abbreviated mental test score >7/10). Intervention: Tailored education comprising patient video and workbook, structured discussion and goal setting led by trained therapist. Main outcomes: Falls in the 6 months after discharge; proportion of participants sustaining one or more falls. Results: There were 382 (194 intervention; 188 control) participants (mean age 77.7 [SD 8.7] years). There were 378 falls (fall rate per 1,000 patient-days, 5.9 intervention; 5.9 control) reported by 164 (42.9%) participants in the 6 months following hospital discharge; 188 (49.7%) of these falls were injurious. There were no significant differences in falls rates between intervention and control groups: (adjusted IRR, 1.09; 95% CI [0.78 to 1.52]) or the proportion of participants who fell once or more (adjusted OR, 1.37; 95% CI [0.90 to 2.07]). Conclusions: Providing individualized falls prevention education prior to discharge did not reduce falls at home after discharge. Further research is warranted to investigate how to reduce falls during this high-risk transition period.
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spelling curtin-20.500.11937-852192021-10-27T07:17:41Z Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education Hill, Anne-Marie McPhail, S.M. Haines, T.P. Morris, M.E. Etherton-Beer, C. Shorr, R. Flicker, L. Bulsara, M. Waldron, N. Lee, D.C.A. Francis-Coad, J. Boudville, A. Newman, A. Science & Technology Life Sciences & Biomedicine Geriatrics & Gerontology Gerontology falls Patient discharge Patient education Randomized controlled trial OLDER-ADULTS INSTRUMENTAL ACTIVITIES PATIENT READMISSION PEOPLE RISK Background: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. Methods: A randomized clinical trial at three hospitals in Western Australia: Participants followed for 6 months after discharge. Baseline and outcomes measured by assessors masked to group allocation. Participants: Aged 60 years and over, admitted for rehabilitation. Eligibility included: Cognitively able to undertake education (Abbreviated mental test score >7/10). Intervention: Tailored education comprising patient video and workbook, structured discussion and goal setting led by trained therapist. Main outcomes: Falls in the 6 months after discharge; proportion of participants sustaining one or more falls. Results: There were 382 (194 intervention; 188 control) participants (mean age 77.7 [SD 8.7] years). There were 378 falls (fall rate per 1,000 patient-days, 5.9 intervention; 5.9 control) reported by 164 (42.9%) participants in the 6 months following hospital discharge; 188 (49.7%) of these falls were injurious. There were no significant differences in falls rates between intervention and control groups: (adjusted IRR, 1.09; 95% CI [0.78 to 1.52]) or the proportion of participants who fell once or more (adjusted OR, 1.37; 95% CI [0.90 to 2.07]). Conclusions: Providing individualized falls prevention education prior to discharge did not reduce falls at home after discharge. Further research is warranted to investigate how to reduce falls during this high-risk transition period. 2019 Journal Article http://hdl.handle.net/20.500.11937/85219 10.1093/gerona/glz026 English OXFORD UNIV PRESS INC fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Geriatrics & Gerontology
Gerontology
falls
Patient discharge
Patient education
Randomized controlled trial
OLDER-ADULTS
INSTRUMENTAL ACTIVITIES
PATIENT
READMISSION
PEOPLE
RISK
Hill, Anne-Marie
McPhail, S.M.
Haines, T.P.
Morris, M.E.
Etherton-Beer, C.
Shorr, R.
Flicker, L.
Bulsara, M.
Waldron, N.
Lee, D.C.A.
Francis-Coad, J.
Boudville, A.
Newman, A.
Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education
title Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education
title_full Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education
title_fullStr Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education
title_full_unstemmed Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education
title_short Falls after Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education
title_sort falls after hospital discharge: a randomized clinical trial of individualized multimodal falls prevention education
topic Science & Technology
Life Sciences & Biomedicine
Geriatrics & Gerontology
Gerontology
falls
Patient discharge
Patient education
Randomized controlled trial
OLDER-ADULTS
INSTRUMENTAL ACTIVITIES
PATIENT
READMISSION
PEOPLE
RISK
url http://hdl.handle.net/20.500.11937/85219