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Conference/Presentation Title: | Responding to the first fall to prevent the second: Successful RCT in reducing falls using a person centred approach for older fallers presenting to emergency departments. | Authors: | Boyle E.;Smit D.;Waldron N.;McDonald E.;Ayton D.;Hill K.;Barker A.;Cameron P.;Flicker L.;Arendts G.;Brand C.;Morello R.;Etherton-Beer C.;Forbes A.;Haines T. ;Hill A.-M.;Hunter P.;Lowthian J.;Nyman S.;Redfern J. | Monash Health Department(s): | Workforce, Innovation, Strategy, Education and Research (WISER) | Institution: | (Hill) Rehabilitation Ageing and Independent Living Research Centre, Monash University, Australia (Barker, Cameron, Brand, Morello, Forbes, Lowthian, Ayton) School of Public Health and Preventive Medicine, Monash University, Australia (Cameron, Hunter, Smit) Alfred Health, Australia (Flicker, Arendts, Etherton-Beer) School of Medicine, University of Western Australia, Australia (Flicker, Etherton-Beer) Department of Geriatric Medicine, Royal Perth Hospital, Australia (Flicker, Arendts, Etherton-Beer) Harry Perkins Institute for Medical Research, Australia (Brand) Melbourne EpiCentre, University of Melbourne, Australia (Brand) Melbourne EpiCentre, Melbourne Health, Melbourne Health, Australia (Haines) School of Primary and Allied Health Care, Monash University, Australia (Haines) Allied Health Research Unit, Monash Health, Australia (Hill, Boyle) School of Physiotherapy and Exercise Science, Curtin University, Australia (Lowthian) Bolton Clarke Research Institute/ Bolton Clarke, Australia (Nyman) Department of Psychology, Faculty of Science and Technology, Bournemouth University, United Kingdom (Redfern) Westmead Applied Research Centre, University of Sydney, Australia (Waldron) Health Networks Branch, Department of Health, Government of Western Australia, Australia (McDonald) Emergency Department, Royal Perth Hospital, Australia | Presentation/Conference Date: | 27-Mar-2020 | Copyright year: | 2019 | Publisher: | Oxford University Press | Publication information: | Age and Ageing. Conference: 1st World Congress on Falls and Postural Stability. Kuala Lumpur Malaysia. 48 (2) (pp iv18), 2019. Date of Publication: December 2019. | Journal: | Age and Ageing | Abstract: | Background:Themajority of older people who fall and present to EmergencyDepartments (EDs) are reported not to receive guideline level care to reduce future risk of falls. The aim of this randomized controlled trial was to evaluate whether RESPOND, a 6-month telephone-based patient-centred program had an effect on falls and fall injuries in older people presenting to ED after a fall. Method(s): 541 older fallers who presented to a WA or Victorian ED were recruited (inclusion criteria: discharged home <72 hours, could walk without hands-on assistance, use a telephone, and no cognitive impairment (MMSE>23). Intervention participants (n=263, mean age=73) received the RESPOND intervention, comprising (1) home-based risk assessment; (2) six months telephone-based education, coaching, goal setting and support for evidence-based risk factor management; and (3) linkages to existing services; while controls (n=260, mean age=73) received usual care. Primary outcomes were falls and fall injuries in the 12-month follow-up. Secondary outcomes included ED presentations, hospital admissions, fractures, death, falls risk, falls efficacy and quality of life. Result(s): Falls rate was significantly lower in the RESPOND group (incidence rate ratio 0.65 [95%CI 0.43-0.99]; p=0.042). Although there was no significant difference in fall injuries (p=0.374), the rate of fractures was significantly lower in the RESPOND group (p=0.03).There were no significant group differences in other secondary outcomes. Conclusion(s): The RESPOND falls prevention program reduced falls and fractures, in older people presenting to the ED with a fall. Key learnings for translation include: potential scalability and sustainability of a patient-centred and predominantly telephonebased program. | Conference Start Date: | 2019-12-04 | Conference End Date: | 2019-12-07 | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1093/ageing/afz164.106 | ISSN: | 1468-2834 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/36442 | Type: | Conference Abstract | Subjects: | education *emergency ward female follow up fracture hospital admission human incidence learning major clinical study aged Mini Mental State Examination outcome assessment quality of life randomized controlled trial risk assessment risk factor telephone male cognitive defect conference abstract controlled study education emergency ward fracture hospital admission learning aged Mini Mental State Examination quality of life telephone cognitive defect major clinical study male Mini Mental State Examination outcome assessment quality of life randomized controlled trial risk assessment risk factor telephone follow up fracture *emergency ward education controlled study conference abstract cognitive defect aged female hospital admission human incidence learning |
Type of Clinical Study or Trial: | Randomised controlled trial |
Appears in Collections: | Conferences |
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