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Age Ageing. 2009 Mar;38(2):194-9. doi: 10.1093/ageing/afn297.

A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT).

Author information

1
Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200MD, The Netherlands. j.neyens@zw

Abstract

OBJECTIVE:

to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients.

DESIGN:

cluster-randomised controlled 12-month trial.

SETTING:

psychogeriatric wards in 12 nursing homes in The Netherlands.

PARTICIPANTS:

psychogeriatric nursing home patients (n = 518).

INTERVENTION:

a general medical assessment and an additional specific fall risk evaluation tool, applied by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities.

MEASUREMENTS:

falls.

RESULTS:

there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward-related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43-0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme.

CONCLUSION:

the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduces the number of falls. This reduction is substantial and of high clinical relevance.

PMID:
19221130
DOI:
10.1093/ageing/afn297
[Indexed for MEDLINE]

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