BMJ 2000;321:994-998 ( 21 October )

General Practice

Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial

Education and debate p 1007

Jolanda C M van Haastregt, health scientist, ^a Jos P M Diederiks, associate professor, ^b Erik van Rossum, assistant professor, ^c Luc P de Witte, executive director, ^a Peter M Voorhoeve, general practitioner, ^e Harry F J M Crebolder, professor. ^d

^a Research Division, Institute for Rehabilitation Research, PO Box 192, 6430 AD Hoensbroek, Netherlands, ^b Department of Medical Sociology, Maastricht University, PO Box 616, 6200 MD Maastricht, Netherlands, ^c Department of Epidemiology, Maastricht University, ^d Department of General Practice, Maastricht University, ^e Primary Care Health Centre Hoensbroek, 6431 HN Hoensbroek, Netherlands

Correspondence to: J C M v Haastregt jolanda.vanhaastregt{at}irv.nl

Objective: To evaluate whether a programme of multifactorial home visits reduces falls and impairments in mobility in elderly people living in the community.
Design: Randomised controlled trial with 18 months of follow up.
Setting: Six general practices in Hoensbroek, the Netherlands.
Participants: 316 people aged 70 and over living in the community, with moderate impairments in mobility or a history of recent falls.
Intervention: Five home visits by a community nurse over a period of one year. Visits consisted of screening for medical, environmental, and behavioural factors causing falls and impairments in mobility, followed by specific advice, referrals, and other actions aimed at dealing with the observed hazards.
Main outcome measures: Falls and impairments in mobility.
Results: No differences were found in falls and mobility outcomes between the intervention and usual care groups.
Conclusion: Multifactorial home visits had no effects on falls and impairments in mobility in elderly people at risk who were living in the community. Because falls and impairments in mobility remain a serious problem among elderly people, alternative strategies should be developed and evaluated.

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