Background A quarter of older fallers requiring ambulance care are subsequently not transported to an emergency department (ED) and due to lack of follow-up care are at high risk for future falls and unplanned health care use. High uptake of and adherence to a falls prevention program are required for an intervention program to be effective at a population level.

Methods A randomised controlled trial investigated the effect of a multidisciplinary, individually tailored fall prevention program offered to older non-transported fallers. Participants comprised 221 people aged ≥65 years. The intervention targeted identified fall risk factors by linking participants with existing healthcare services as appropriate and providing proactive assistance. The control group received written fall prevention advice. Intention to adhere to the intervention was assessed with the AFRIS scale at baseline in the intervention group. Adherence to protocol was reassessed after six months and falls and health service use were monitored for 12 months.

Results Baseline intention to adhere scores (AFRIS) were predictive of adherence rates. Significantly more intervention group participants (proactive assistance) adhered to all recommendations, compared to control group participants (written advice). Adherence was independent of any confounding factors. Adherence with proactive assistance resulted in significantly fewer falls and subsequent health service use compared to non-adhering participants and those who received written advice only. No significant benefit or harm was observed by adhering to written advice.

Conclusions Assistance to implement fall prevention interventions, when targeted at individuals intending to adhere to the tailored recommendations, offers significant benefit for participants, regardless of their medical history and fall risk factors. Written advice alone was unable to significantly influence primary outcome measures.