Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial

doi:10.1136/bmj.328.7441.676

BMJ 2004;328:676 (20 March), doi:10.1136/bmj.328.7441.676

Paper

Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial

Terry P Haines, PhD candidate¹, Kim L Bennell, associate professor¹, Richard H Osborne, senior lecturer², Keith D Hill, senior research fellow³

¹ University of Melbourne School of Physiotherapy, Parkville, Victoria 3052, Australia, ² Centre for Rheumatic Disease, Royal Melbourne Hospital and the University of Melbourne, Parkville, ³ National Ageing Research Institute and Melbourne Extended Care and Rehabilitation Service, Parkville

Correspondence to: K Hill k.hill{at}nari.unimelb.edu.au

Objective To assess the effectiveness of a targeted, multipleintervention falls prevention programme in reducing falls andinjuries related to falls in a subacute hospital.

Design Randomised controlled trial of a targeted multiple interventionprogramme implemented in addition to usual care compared withusual care alone.

Setting Three subacute wards in a metropolitan hospital specialisingin rehabilitation and care of elderly patients.

Participants 626 men and women aged 38 to 99 years (average80 years) were recruited from consecutive admissions to subacutehospital wards.

Intervention Falls risk alert card with information brochure,exercise programme, education programme, and hip protectors.

Main outcome measures Incidence rate of falls, injuries relatedto falls, and proportion of participants who experienced oneor more falls during their stay in hospital.

Results Participants in the intervention group (n = 310) experienced30% fewer falls than participants in the control group (n =316). This difference was significant (Peto log rank test P= 0.045) and was most obvious after 45 days of observation.In the intervention group there was a trend for a reductionin the proportion of participants who experienced falls (relativerisk 0.78, 95% confidence interval 0.56 to 1.06) and 28% fewerfalls resulted in injury (log rank test P = 0.20).

Conclusions A targeted multiple intervention falls preventionprogramme reduces the incidence of falls in the subacute hospitalsetting.

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Rapid Responses:

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Community Falls Assessment: Sudarshini Ramanathan, et al.
bmj.com, 8 Apr 2004 [Full text]
Are all falls equal?: Meghan G. Donaldson, et al.
bmj.com, 13 May 2004 [Full text]
Re: Are all falls equal?: Terry P Haines, et al.
bmj.com, 9 Jun 2004 [Full text]