Anna Barker|Peter Cameron|Leon Flicker|Glenn Arendts|Caroline Brand|Christopher Etherton?Beer|Andrew Forbes|Terry Haines|Anne-Marie Hill|Peter Hunter|Judy Lowthian|Samuel R. Nyman|Julie Redfern|De Villiers Smit|Nicholas Waldron|Eileen M. Boyle|Ellen MacDonald|Darshini Ayton|Renata Morello|Keith Hill
Evaluation of RESPOND, a patient-centred program to prevent falls in older people presenting to the emergency department with a fall: A randomised controlled trial
Monash University|Alfred Health|Monash University|Royal Perth Hospital|Harry Perkins Institute of Medical Research|University of Western Australia|Harry Perkins Institute of Medical Research|University of Western Australia|Melbourne Health|Monash University|University of Melbourne|Royal Perth Hospital|Harry Perkins Institute of Medical Research|University of Western Australia|Monash University|Monash Health|Monash University|Curtin University|Alfred Health|Monash University|Bournemouth University|Westmead Institute|University of Sydney|Alfred Health|Government of Western Australia|Government of Western Australia Department of Health|Curtin University|Royal Perth Hospital|Monash University|Monash University|Curtin University
background falls leading reason older people presenting emergency department ed many experience falls little evidence exists guide secondary prevention population randomised controlled trial rct investigated whether 6month telephonebased patientcentred programrespondhad effect falls fall injuries older people presenting ed fall methods findings communitydwelling people aged 6090 years presenting ed fall planned discharge home within 72 hours recruited two eds australia participants enrolled could walk without handson assistance use telephone free cognitive impairment minimental state examination 23 recruitment occurred 1 april 2014 29 june 2015 participants randomised receive either respond intervention usual care control respond comprised 1 homebased risk assessment 2 6 months telephonebased education coaching goal setting support evidencebased risk factor management 3 linkages existing services primary outcomes falls fall injuries 12month followup secondary outcomes included ed presentations hospital admissions fractures death falls risk falls efficacy quality life assessors blind group allocation collected outcome data via postal calendars telephone followup hospital records 430 people primary outcome analysis217 randomised respond 213 control mean age participants 73 years 55 female falls per personyear 115 respond group 183 control incidence rate ratio irr 065 95 ci 043099 p 0042 significant difference fall injuries irr 081 051129 p 0374 rate fractures significantly lower respond group compared control 005 versus 012 irr 037 95 ci 015091 p 003 significant differences secondary outcomes groups ed presentations hospitalisations falls risk falls efficacy quality life two deaths respond group one control group adverse events unintended harm reported limitations study high number dropouts n 93 possible underreporting falls fall injuries hospitalisations across groups relatively small number fracture events conclusions study providing telephonebased patientcentred falls prevention program reduced falls fall injuries older people presenting ed fall among secondary outcomes fractures reduced adopting patientcentred strategies routine clinical practice falls prevention could offer opportunity improve outcomes reduce falls patients attending ed trial registration australian new zealand clinical trials registry actrn12614000336684