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Multifactorial falls prevention programmes for older adults presenting to the Emergency Department with a fall: systematic review and meta-analysis.

Morello, R.M., Soh, S-E., Behm, K., Egan, A., Ayton, D.R., Hill, K.D., Flicker, L., Etherton-Beer, C.D., Arendts, G., Waldron, N., Redfern, J., Haines, T., Lowthian, J., Nyman, S., Cameron, P., Fairhall, N. and Barker, A.L., 2019. Multifactorial falls prevention programmes for older adults presenting to the Emergency Department with a fall: systematic review and meta-analysis. Injury Prevention, 25 (6), 557-564.

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DOI: 10.1136/injuryprev-2019-043214

Abstract

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.

Item Type:Article
ISSN:1353-8047
Uncontrolled Keywords:accidental falls; systematic review; emergency department; fall prevention; elderly
Group:Faculty of Science & Technology
ID Code:32204
Deposited By: Unnamed user with email symplectic@symplectic
Deposited On:29 Apr 2019 10:44
Last Modified:07 Jan 2020 13:03

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