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The Effects and Costs of a Multifactorial and Interdisciplinary Team Approach to Falls Prevention for Older Home Care Clients ‘At Risk’ for Falling: A Randomized Controlled Trial*

Published online by Cambridge University Press:  04 March 2010

Maureen Markle-Reid ,
Gina Browne ,
Amiram Gafni ,
Jacqueline Roberts ,
Robin Weir ,
Lehana Thabane ,
Melody Miles ,
Vida Vaitonis ,
Catherine Hecimovich  and
Pamela Baxter
...Show all authors
Maureen Markle-Reid*
Affiliation:
McMaster University
Gina Browne
Affiliation:
McMaster University
Amiram Gafni
Affiliation:
McMaster University
Jacqueline Roberts
Affiliation:
McMaster University
Robin Weir
Affiliation:
McMaster University
Lehana Thabane
Affiliation:
McMaster University
Melody Miles
Affiliation:
McMaster University
Vida Vaitonis
Affiliation:
McMaster University
Catherine Hecimovich
Affiliation:
McMaster University
Pamela Baxter
Affiliation:
McMaster University
Sandra Henderson
Affiliation:
McMaster University
*
†Correspondence concerning this article should be addressed to / La correspondance concernant cet article doit être adressées à: Maureen Markle-Reid, RN, Ph.D., McMaster University, School of Nursing, 1200 Main Street West, HSC 3N28H, Hamilton, Ontario L8N 3Z5 (mreid@mcmaster.ca)
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Abstract

This study determined the effects and costs of a multifactorial, interdisciplinary team approach to falls prevention. Randomized controlled trial of 109 older adults who are at risk for falls. This was a six-month multifactorial and evidence-based prevention strategy involving an interdisciplinary team. The primary outcome was number of falls during the six-month follow-up. At six months, no difference in the mean number of falls between groups. Subgroup analyses showed that the intervention effectively reduced falls in men (75–84 years old) with a fear of falling or negative fall history. Number of slips and trips was greatly reduced; and emotional health had a greater improvement in role functioning related to emotional health in the intervention group. Quality of life was improved, slips and trips were reduced, as were falls among males (75–84 years old) with a fear of falling or negative fall history.

Résumé

Cette étude a déterminé les effets et les coûts d’une approche d’équipe multifactoriel et interdisciplinaire à la prévention des chutes. Essai contrôlé aléatoire de 109 adultes plus âgés qui sont à risque de chutes. Ce fut une stratégie de prévention multifactoriel fondée sur des données probantes de 6 mois, impliquant une équipe interdisciplinaire. Le résultat principal a été le nombre des chutes suivi pendant 6 mois. À 6 mois, il n’y a aucune différence dans le nombre moyen de chutes entre groupes. Des analyses des sous-groupes ont montrés que l’intervention réduit efficacement les chutes chez les hommes (75–84 ans) qui ont peur de tomber ou une histoire négative de chutes. Le nombre de glissades et de trébuchés a été considérablement réduit, et la santé émotionnelle a montré une amélioration plus importante dans le fonctionnement lié à la santé émotionnelle dans le groupe d’intervention. La qualité de vie a été améliorée, glissades et trébuchés ont été réduits, comme l’étaient les chutes chez les hommes qui avaient peur de tomber ou une histoire de chutes négative.

Keywords

chutes accidentellespersonnes agées communautairesservices d’aide familialepopulation de soins à domicilepromotion de la santépréventionmaladie chroniqueefficacité cliniquecoûtséquipe de soins multidisciplinairesprocès aléatoireaccidental fallscommunity-based seniorshomemaker serviceshome care populationhealth promotionpreventionchronic illnessclinical effectivenesscostsmultidisciplinary care teamrandomized trial
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 29 , Issue 1: Special Issue from the Social and Economic Dimensions of an Aging Population Project (SEDAP) – Caring for an Aging Population: Context, Practice & Policy , March 2010 , pp. 139 - 161
Copyright
Copyright © Canadian Association on Gerontology 2010

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Footnotes

*

We are grateful to the following agencies for funding this project from 2005 to 2008: Canadian Patient Safety Institute (CPSI – Grant Number RFAAA0506164), Community Care Access Centre of Halton, McMaster University System-Linked Research Unit on Health and Social Services Utilization, and Ontario Ministry of Health and Long-Term Care. Maureen Markle-Reid is a Career Scientist, Ontario Ministry of Health and Long-Term Care, Health Research Personnel Development Fund. This research was possible through the ongoing support of the Community Care Access Centre of Halton, Hamilton Niagara Haldimand Brant Community Care Access Centre, Mississauga Halton Community Care Access Centre, Halton Region Health Department, Community Rehab, Ellen Williams, Brant Arts Dispensary, and Dr. Heather H. Keller, Department of Family Relations and Applied Human Nutrition, Macdonald Institute, University of Guelph. We are also grateful to the following individuals: Darlene Lane (project coordination), Leah Macdonald (data entry), Maria Wong (data analysis), and Rachel Harvey (administrative support).

Trial Registration:clinicaltrials.gov identifier: NCT00463658.

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