Falls after hospital discharge

a randomized clinical trial of individualized multi-modal falls prevention education

Anne-Marie Hill, Steven McPhail, Terry Haines, Megan Morris, Christopher Etherton-Beer, Ron Shorr, Leon Flicker, Max Bulsara, Nicholas Waldron, Den-Ching Angel Lee, Jacqueline Francis-Coad, Amanda Boudville

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. Methods: A randomized clinical trial at three hospitals in Western Australia: participants followed for six months after discharge. Baseline and outcomes measured by assessors masked to group allocation. Participants: aged 60 years and over, admitted for rehabilitation. Eligibility included: cognitively able to undertake education (Abbreviated mental test score >7/10). Intervention: tailored education comprising patient video and workbook, structured discussion and goal setting led by trained therapist. Main outcomes: falls in the six months after discharge; proportion of participants sustaining one or more falls. Results: There were 382 (194 intervention; 188 control) participants [mean age 77.7 (SD 8.7) years]. There were 378 falls (fall rate/1000 patient days, 5.9 intervention; 5.9 control) reported by 164 (42.9%) participants in the six months following hospital discharge; 188 (49.7%) of these falls were injurious. There were no significant differences in falls rates between intervention and control groups: [adjusted IRR, 1.09; 95% CI (0.78 to 1.52)] or the proportion of participants who fell once or more [adjusted OR, 1.37; 95% CI (0.90 to 2.07)]. Conclusions: Providing individualized falls prevention education prior to discharge did not reduce falls at home after discharge. Further research is warranted to investigate how to reduce falls during this high risk transition period.
Original languageEnglish
Number of pages7
JournalJournal of Gerontology Series A: Biological Sciences and Medical Sciences
DOIs
Publication statusAccepted/In press - 5 Feb 2019

Cite this

Hill, Anne-Marie ; McPhail, Steven ; Haines, Terry ; Morris, Megan ; Etherton-Beer, Christopher ; Shorr, Ron ; Flicker, Leon ; Bulsara, Max ; Waldron, Nicholas ; Lee, Den-Ching Angel ; Francis-Coad, Jacqueline ; Boudville, Amanda. / Falls after hospital discharge : a randomized clinical trial of individualized multi-modal falls prevention education. In: Journal of Gerontology Series A: Biological Sciences and Medical Sciences. 2019.
@article{e9861f5d8039450daea6d9a0ac174ad1,
title = "Falls after hospital discharge: a randomized clinical trial of individualized multi-modal falls prevention education",
abstract = "Background: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. Methods: A randomized clinical trial at three hospitals in Western Australia: participants followed for six months after discharge. Baseline and outcomes measured by assessors masked to group allocation. Participants: aged 60 years and over, admitted for rehabilitation. Eligibility included: cognitively able to undertake education (Abbreviated mental test score >7/10). Intervention: tailored education comprising patient video and workbook, structured discussion and goal setting led by trained therapist. Main outcomes: falls in the six months after discharge; proportion of participants sustaining one or more falls. Results: There were 382 (194 intervention; 188 control) participants [mean age 77.7 (SD 8.7) years]. There were 378 falls (fall rate/1000 patient days, 5.9 intervention; 5.9 control) reported by 164 (42.9{\%}) participants in the six months following hospital discharge; 188 (49.7{\%}) of these falls were injurious. There were no significant differences in falls rates between intervention and control groups: [adjusted IRR, 1.09; 95{\%} CI (0.78 to 1.52)] or the proportion of participants who fell once or more [adjusted OR, 1.37; 95{\%} CI (0.90 to 2.07)]. Conclusions: Providing individualized falls prevention education prior to discharge did not reduce falls at home after discharge. Further research is warranted to investigate how to reduce falls during this high risk transition period.",
author = "Anne-Marie Hill and Steven McPhail and Terry Haines and Megan Morris and Christopher Etherton-Beer and Ron Shorr and Leon Flicker and Max Bulsara and Nicholas Waldron and Lee, {Den-Ching Angel} and Jacqueline Francis-Coad and Amanda Boudville",
year = "2019",
month = "2",
day = "5",
doi = "10.1093/gerona/glz026",
language = "English",
journal = "Journal of Gerontology Series A: Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",

}

Falls after hospital discharge : a randomized clinical trial of individualized multi-modal falls prevention education. / Hill, Anne-Marie; McPhail, Steven ; Haines, Terry; Morris, Megan; Etherton-Beer, Christopher; Shorr, Ron; Flicker, Leon; Bulsara, Max; Waldron, Nicholas; Lee, Den-Ching Angel; Francis-Coad, Jacqueline; Boudville, Amanda.

In: Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 05.02.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Falls after hospital discharge

T2 - a randomized clinical trial of individualized multi-modal falls prevention education

AU - Hill, Anne-Marie

AU - McPhail, Steven

AU - Haines, Terry

AU - Morris, Megan

AU - Etherton-Beer, Christopher

AU - Shorr, Ron

AU - Flicker, Leon

AU - Bulsara, Max

AU - Waldron, Nicholas

AU - Lee, Den-Ching Angel

AU - Francis-Coad, Jacqueline

AU - Boudville, Amanda

PY - 2019/2/5

Y1 - 2019/2/5

N2 - Background: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. Methods: A randomized clinical trial at three hospitals in Western Australia: participants followed for six months after discharge. Baseline and outcomes measured by assessors masked to group allocation. Participants: aged 60 years and over, admitted for rehabilitation. Eligibility included: cognitively able to undertake education (Abbreviated mental test score >7/10). Intervention: tailored education comprising patient video and workbook, structured discussion and goal setting led by trained therapist. Main outcomes: falls in the six months after discharge; proportion of participants sustaining one or more falls. Results: There were 382 (194 intervention; 188 control) participants [mean age 77.7 (SD 8.7) years]. There were 378 falls (fall rate/1000 patient days, 5.9 intervention; 5.9 control) reported by 164 (42.9%) participants in the six months following hospital discharge; 188 (49.7%) of these falls were injurious. There were no significant differences in falls rates between intervention and control groups: [adjusted IRR, 1.09; 95% CI (0.78 to 1.52)] or the proportion of participants who fell once or more [adjusted OR, 1.37; 95% CI (0.90 to 2.07)]. Conclusions: Providing individualized falls prevention education prior to discharge did not reduce falls at home after discharge. Further research is warranted to investigate how to reduce falls during this high risk transition period.

AB - Background: Older people are at high risk of falls after hospital discharge. The study aimed to evaluate the effect of providing individualized falls prevention education in addition to usual care on falls rates in older people after hospital discharge compared to providing a social intervention in addition to usual care. Methods: A randomized clinical trial at three hospitals in Western Australia: participants followed for six months after discharge. Baseline and outcomes measured by assessors masked to group allocation. Participants: aged 60 years and over, admitted for rehabilitation. Eligibility included: cognitively able to undertake education (Abbreviated mental test score >7/10). Intervention: tailored education comprising patient video and workbook, structured discussion and goal setting led by trained therapist. Main outcomes: falls in the six months after discharge; proportion of participants sustaining one or more falls. Results: There were 382 (194 intervention; 188 control) participants [mean age 77.7 (SD 8.7) years]. There were 378 falls (fall rate/1000 patient days, 5.9 intervention; 5.9 control) reported by 164 (42.9%) participants in the six months following hospital discharge; 188 (49.7%) of these falls were injurious. There were no significant differences in falls rates between intervention and control groups: [adjusted IRR, 1.09; 95% CI (0.78 to 1.52)] or the proportion of participants who fell once or more [adjusted OR, 1.37; 95% CI (0.90 to 2.07)]. Conclusions: Providing individualized falls prevention education prior to discharge did not reduce falls at home after discharge. Further research is warranted to investigate how to reduce falls during this high risk transition period.

U2 - 10.1093/gerona/glz026

DO - 10.1093/gerona/glz026

M3 - Article

JO - Journal of Gerontology Series A: Biological Sciences and Medical Sciences

JF - Journal of Gerontology Series A: Biological Sciences and Medical Sciences

SN - 1079-5006

ER -