Abstract of the Week: multifactorial fall prevention in practice

I’m seeing a new outpatient for falls, and came across this study today. I interned at HMC and had the opportunity to meet with Dr. Phelan but was not able to visit the falls prevention clinic. Our outpatient program is just now taking off, so it will be interesting to read further on this.

Moore M, Williams B, Ragsdale S, LoGerfo JP, Goss JR, Schreuder AB, Phelan EA. Translating a Multifactorial Fall Prevention Intervention into Practice: A Controlled Evaluation of a Fall Prevention Clinic. J Am Geriatr Soc 2010; 58:357–363.

Although multifactorial fall prevention interventions have been shown to reduce falls and injurious falls, their translation into clinical settings has been limited. This article describes a hospital-based fall prevention clinic established to increase availability of preventive care for falls. Outcomes for 43 adults aged 65 and older seen during the clinic’s first 6 months of operation were compared with outcomes for 86 age-, sex-, and race-matched controls; all
persons included in analyses received primary care at the hospital’s geriatrics clinic. Nonsignificant differences in
falls, injurious falls, and fall-related healthcare use according to study group in multivariate adjusted models were
observed, probably because of the small, fixed sample size.   The percentage experiencing any injurious falls during the
follow-up period was comparable for fall clinic visitors and controls (14% vs 13%), despite a dramatic difference at
baseline (42% of clinic visitors vs 15% of controls). Fall-related healthcare use was higher for clinic visitors during the
baseline period (21%, vs 12% for controls) and decreased slightly (to 19%) during follow-up; differences in fall-related
healthcare use according to study group from baseline to follow-up were nonsignificant. These findings, although preliminary because of the small sample size and the baseline difference between the groups in fall rates, suggest that being seen in a fall prevention clinic may reduce injurious falls. Additional studies will be necessary to conclusively determine the effects of multifactorial fall risk assessment and management delivered by midlevel providers working in
real-world clinical practice settings on key outcomes, including injurious falls, downstream fall-related healthcare
use, and costs.

Photo credit: abstract yellow scraped tank, originally uploaded by zen