RT Journal Article
SR Electronic
T1 Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: systematic review and meta-analysis
JF Injury Prevention
JO Inj Prev
FD BMJ Publishing Group Ltd
SP 557
OP 564
DO 10.1136/injuryprev-2019-043214
VO 25
IS 6
A1 Renata Teresa Morello
A1 Sze-Ee Soh
A1 Kate Behm
A1 Amy Egan
A1 Darshini Ayton
A1 Keith Hill
A1 Leon Flicker
A1 Christopher D Etherton-Beer
A1 Glenn Arendts
A1 Nicholas Waldron
A1 Julie Redfern
A1 Terrence Haines
A1 Judy Lowthian
A1 Samuel R Nyman
A1 Peter Cameron
A1 Nicola Fairhall
A1 Anna Lucia Barker
YR 2019
UL http://injuryprevention.bmj.com/content/25/6/557.abstract
AB Objective To determine whether multifactorial falls prevention interventions are effective in preventing falls, fall injuries, emergency department (ED) re-presentations and hospital admissions in older adults presenting to the ED with a fall.Design Systematic review and meta-analyses of randomised controlled trials (RCTs).Data sources Four health-related electronic databases (Ovid MEDLINE, CINAHL, EMBASE, PEDro and The Cochrane Central Register of Controlled Trials) were searched (inception to June 2018).Study selection RCTs of multifactorial falls prevention interventions targeting community-dwelling older adults ( ≥ 60 years) presenting to the ED with a fall with quantitative data on at least one review outcome.Data extraction Two independent reviewers determined inclusion, assessed study quality and undertook data extraction, discrepancies resolved by a third.Data synthesis 12 studies involving 3986 participants, from six countries, were eligible for inclusion. Studies were of variable methodological quality. Multifactorial interventions were heterogeneous, though the majority included education, referral to healthcare services, home modifications, exercise and medication changes. Meta-analyses demonstrated no reduction in falls (rate ratio = 0.78; 95% CI: 0.58 to 1.05), number of fallers (risk ratio = 1.02; 95% CI: 0.88 to 1.18), rate of fractured neck of femur (risk ratio = 0.82; 95% CI: 0.53 to 1.25), fall-related ED presentations (rate ratio = 0.99; 95% CI: 0.84 to 1.16) or hospitalisations (rate ratio = 1.14; 95% CI: 0.69 to 1.89) with multifactorial falls prevention programmes.Conclusions There is insufficient evidence to support the use of multifactorial interventions to prevent falls or hospital utilisation in older people presenting to ED following a fall. Further research targeting this population group is required.