Evidence-based clinical practice in falls prevention: a randomised controlled trial of a falls prevention service

Abstract

Aims:Evidence-based guidelines recommend a range of treatments for falls and injury prevention. We undertook arandomised trial of a falls prevention service to screen for falls risk factors and recommend to GPs an evidenced baseprescription for falls prevention.Methods:All patients who presented with a fall to the Emergency Department at Flinders Medical Centre over a 22-week periodwere considered for the study. We excluded patients with dementia, resident in high care or those transferred to otherhospitals and outside our catchment area. Of those who consented, we randomised patients between usual care or toan intervention consisting of a falls risk assessment and writing of an evidence-based prescription faxed to their GPfor action. Patients were followed for six months and uptake of advice and fall rates were monitored.Results:Four hundred and fifty patients presented with a fall-related attendance and of these 261 patients were eligible forinclusion in the trial. Of these 261 patients, 140 consented and were enrolled in the trial. Over the six monthspatients in the intervention group were more likely to uptake preventative advice (OR=12.3; 95%CI=4.2-35.9).We were unable to show a reduction in falls (OR=1.7; 95%CI=0.7-4.4).Conclusions:A patient centered evidence-based approach is feasible and effective in increasing uptake of falls prevention advice.Long term compliance with advice needs further exploration.