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RESPOND—a patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall: protocol for a multicentre randomised controlled trial
  1. A L Barker1,
  2. P A Cameron1,
  3. K D Hill2,
  4. L Flicker3,4,5,
  5. T P Haines6,
  6. J A Lowthian1,
  7. N Waldron7,
  8. G Arendts3,5,
  9. J Redfern8,
  10. A Forbes9,
  11. C A Brand1,10,
  12. C D Etherton-Beer3,4,5,
  13. A M Hill11,
  14. P Hunter12,
  15. S R Nyman13,
  16. D Smit12
  1. 1Health Services Research Unit, Centre of Research Excellence in Patient Safety, Division of Health Services and Global Health Research, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia, Australia
  3. 3University of Western Australia, Perth, Western Australia, Australia
  4. 4Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
  5. 5Harry Perkins Institute for Medical Research, Perth, Western Australia, Australia
  6. 6Department of Physiotherapy, Monash University, and Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia
  7. 7Health Networks Branch, System Policy and Planning, Department of Health, Government of Western Australia, Perth, Western Australia, Australia
  8. 8The George Institute for Global Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
  9. 9Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  10. 10Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
  11. 11School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  12. 12Alfred Health, Melbourne, Victoria, Australia
  13. 13Bournemouth University Dementia Institute and Psychology Department, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK
  1. Correspondence to Dr Anna Barker, DEPM, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia; anna.barker{at}monash.edu

Abstract

Introduction Participation in falls prevention activities by older people following presentation to the emergency department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND programme, an intervention designed to improve older persons’ participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies.

Design and setting A RCT at two tertiary referral EDs in Melbourne and Perth, Australia.

Participants 528 community-dwelling people aged 60–90 years presenting to the ED with a fall and discharged home will be recruited. People who require an interpreter or hands-on assistance to walk; live in residential aged care or >50 km from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or a history of psychosis; are receiving palliative care or are unable to use a telephone will be excluded.

Methods Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates (1) a home-based risk factor assessment; (2) education, coaching, goal setting and follow-up telephone support for management of one or more of four risk factors with evidence of effective interventions and (3) healthcare provider communication and community linkage delivered over 6 months. Primary outcomes are falls and fall injuries per person-year.

Discussion RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease; however, evidence to support this approach in falls prevention is limited.

Trial registration number The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684).

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