Fall prevention strategies have been paid a fair amount of scientific attention as of late. Last month, I wrote on this blog about two researchers from The University of Texas Medical School at Houston who argued that falls in hospitals should not be classified as preventable. And now, two researchers from IPC The Hospitalist Company have released a 10-year review on the effectiveness of fall prevention programs for older adults, finding that such interventions are only “modestly effective.”
The literature review, recently published in the Journal of the American Medical Directors Association (JAMDA), studied articles on fall prevention strategies and interventions found in five electronic databases from 2000-2009, which included data from nursing homes and communities for older adults.
Melvin Hector, MD, a clinical associate professor at University of Arizona College of Medicine; and Myunghan Choi, PhD, MPH, APRN-BC, assistant research professor at Arizona State University College of Nursing and Health Innovation, wrote that their analysis indicates that randomized controlled trials of fall prevention programs conducted within this timeframe were effective in a 9% overall reduction of fall rates.
The purpose of the study, they wrote, is there has been no recent meta-analysis indicating that newly developed fall prevention programs are any more or less reliably effective in preventing falls for older adults. The analysis was therefore an attempt to derive scientific evidence of the effectiveness of fall prevention programs and to make recommendations to healthcare providers.
And they did make recommendations, writing that providers can do the following to attempt a reduction in falls: “(1) identify an individual’s risk factors for falls; (2) determine predisposing and precipitating factors if the patient has a history of falls, and intervene accordingly; (3) provide intervention programs and management focusing on lower-extremity balance and strengthening; (4) consider psychological factors such as fear of falling and self-imposed restriction of activity; and (5) classify injuries when they do occur based on the International Classification of Diseases (10th revision, classification system).”
Do these recommendations sound new to you? Probably not, especially if you’ve been following some form of fall prevention, which may indicate that even a 9% reduction in falls shows that your attempts at intervention programs do work in some capacity. After all, even the researchers acknowledged that defining the most effective intervention for a frail older adult population is not going to be likely anytime soon. With 10 years of research under review, the basic advice is still to stay the course and remain observant of your residents.