BMJ  2008;336:343 (16 February), doi:10.1136/bmj.39486.498866.3A

Letters

Preventing falls

Direct intervention is needed

The first 150 words of the full text of this article appear below.

Gates et al conclude that the evidence base is weak for the effectiveness of multifactorial interventions to prevent falls in primary care, the community, and emergency care.¹ However, the 19 studies they reviewed are not all trials of multifactorial assessments and targeted interventions.

These 19 trials require sorting into three more clinically relevant groups: those that are not truly multifactorial (three), those entailing assessment and referral but no direct intervention (10), and those entailing multifactorial assessment and direct intervention (six).

Analysed in this way, four of the six trials in the more important third group are either clearly positive or had a favourable risk ratio but insufficient power, and only two were negative. Seven of the 10 trials of assessment and referral, but without direct intervention, were negative. In one of the three trials of physical therapy, falls were not a primary or secondary outcome measure, so it should not . . . [Full text of this article]

¹ LifeCare, Shelton, CT 06484, USA

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis

S Gates, J D Fisher, M W Cooke, Y H Carter, and S E Lamb
BMJ 2008 336: 130-133. [Abstract] [Full Text] [PDF]

Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials

John T Chang, Sally C Morton, Laurence Z Rubenstein, Walter A Mojica, Margaret Maglione, Marika J Suttorp, Elizabeth A Roth, and Paul G Shekelle
BMJ 2004 328: 680. [Abstract] [Full Text] [PDF]