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Systematic Reviews
Published in: Systematic Reviews 1/2013

Open Access 01-12-2013 | Protocol

Efficacy of falls prevention interventions: protocol for a systematic review and network meta-analysis

Authors: Andrea C Tricco, Elise Cogo, Jayna Holroyd-Leduc, Kathryn M Sibley, Fabio Feldman, Gillian Kerr, Sumit R Majumdar, Susan Jaglal, Sharon E Straus

Published in: Systematic Reviews | Issue 1/2013

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Abstract

Background

Falls are a leading cause of morbidity and mortality in older adults. Although numerous trials of falls prevention interventions have been completed, there is extensive variation in their intervention components and clinical context, such that the key elements of an effective falls prevention program remain unclear to patients, clinicians, and policy-makers. Our objective is to identify the most effective interventions and combinations of interventions that prevent falls though a systematic review and meta-analysis, including a network meta-analysis.

Methods/Design

We will search for published (e.g., MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Ageline) and unpublished (e.g., trial registries, dissertations) randomised clinical trials (RCTs) in all languages examining interventions to prevent falls compared to usual care or other falls prevention interventions among adults aged ≥65 years from all settings (e.g., community, acute care, long-term care, and rehabilitation). The primary outcomes are number of injurious falls and number of hospitalizations due to falls. Secondary outcomes include falls rate, number of fallers, number of emergency room visits due to falls, number of physician visits due to falls, number of fractures, costs, and number of intervention-related harms (e.g., muscle soreness related to exercise).
We will calibrate our eligibility criteria amongst the team and two independent team members will screen the literature search results in duplicate. Conflicts will be resolved through team discussion. A similar process will be used for data abstraction and quality appraisal with the Cochrane risk of bias tool.
Our results will be synthesized descriptively and a random effects meta-analysis will be conducted if the studies are deemed methodologically, clinically, and statistically (e.g., I2<60%) similar. If appropriate, a network meta-analysis will be conducted, which will allow the comparison of interventions that have not been compared in head-to-head RCTs, as well as the effectiveness of interventions.

Discussion

We will identify the most effective interventions and combinations of interventions that prevent falls in older people. Our results will be used to optimize falls prevention strategies, and our goal is to ultimately improve the health of seniors internationally.

Systematic review registration

PROSPERO registry number: CRD42013004151
Literature
1.
Buchner DM, Hornbrook MC, Kutner NG, Tinetti ME, Ory MG, Mulrow CD, Schechtman KB, Gerety MB, Fiatarone MA, Wolf SL: Development of the common data base for the FICSIT trials. J Am Geriatr Soc. 1993, 41: 297-308.CrossRefPubMed
2.
Scuffham P, Chaplin S, Legood R: Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health. 2003, 57: 740-744. 10.1136/jech.57.9.740.CrossRefPubMedPubMedCentral
3.
Akyol AD: Falls in the elderly: what can be done?. Int Nurs Rev. 2007, 54: 191-196. 10.1111/j.1466-7657.2007.00505.x.CrossRefPubMed
4.
O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S: Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993, 137: 342-354.PubMed
5.
World Health Organization: WHO Global Report on Falls Prevention in Older Age. 2007, Geneva: WHO Press
6.
MoHaL-T MAS: Prevention of falls and fall-related injuries in community-dwelling seniors. Ont Health Technol Assess Ser. 2008, 8: 42-119.
7.
Rubenstein LZ: Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006, 35 (Suppl 2): ii37-ii41.PubMed
8.
Woolcott JC, Khan KM, Mitrovic S, Anis AH, Marra CA: The cost of fall related presentations to the ED: a prospective, in-person, patient-tracking analysis of health resource utilization. Osteoporos Int. 2012, 23: 1513-1519. 10.1007/s00198-011-1764-1.CrossRefPubMed
9.
de Kam D, Smulders E, Weerdesteyn V, Smits-Engelsman BC: Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials. Osteoporos Int. 2009, 20: 2111-2125. 10.1007/s00198-009-0938-6.CrossRefPubMed
10.
McGilton KS, Mahomed N, Davis AM, Flannery J, Calabrese S: Outcomes for older adults in an inpatient rehabilitation facility following hip fracture (HF) surgery. Arch Gerontol Geriatr. 2009, 49: e23-e31. 10.1016/j.archger.2008.07.012.CrossRefPubMed
11.
Michael YL, Lin JS, Whitlock EP, Gold R, Fu R, O’Connor EA, Zuber SP, Beil TL, Lutz KW: Interventions to Prevent Falls in Older Adults: An Updated Systematic Review. 2010, Rockville (MD): U.S. Preventive Services Task Force Evidence Syntheses, [formerly Systematic Evidence Reviews]
12.
Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, Rowe BH: Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009, Issue 2: CD007146-PubMed
13.
Cameron ID, Murray GR, Gillespie LD, Robertson MC, Hill KD, Cumming RG, Kerse N: Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev. 2010, Issue 1: CD005465-PubMed
14.
Kalyani RR, Stein B, Valiyil R, Manno R, Maynard JW, Crews DC: Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis. J Am Geriatr Soc. 2010, 58: 1299-1310. 10.1111/j.1532-5415.2010.02949.x.CrossRefPubMedPubMedCentral
15.
16.
17.
Sampson M, McGowan J, Cogo E, Grimshaw J, Moher D, Lefebvre C: An evidence-based practice guideline for the peer review of electronic search strategies. J Clin Epidemiol. 2009, 62: 944-952. 10.1016/j.jclinepi.2008.10.012.CrossRefPubMed
18.
Glasziou P, Meats E, Heneghan C, Shepperd S: What is missing from descriptions of treatment in trials and reviews?. BMJ. 2008, 336: 1472-1474. 10.1136/bmj.39590.732037.47.CrossRefPubMedPubMedCentral
19.
Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA: The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011, 343: d5928-10.1136/bmj.d5928.CrossRefPubMedPubMedCentral
20.
Lexchin J, Bero LA, Djulbegovic B, Clark O: Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ. 2003, 326: 1167-1170. 10.1136/bmj.326.7400.1167.CrossRefPubMedPubMedCentral
21.
Rao JN, Scott AJ: A simple method for the analysis of clustered binary data. Biometrics. 1992, 48: 577-585. 10.2307/2532311.CrossRefPubMed
22.
23.
SAS: version 9.1. 2004, Cary, NC: SAS institute
24.
Song F, Altman DG, Glenny AM, Deeks JJ: Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses. BMJ. 2003, 326: 472-10.1136/bmj.326.7387.472.CrossRefPubMedPubMedCentral
25.
Lunn DJ, Thomas A, Best N, Spiegelhalter D: MRC Biostatistics Unit. 2000, Cambridge, England: Statistics and Computing
26.
Cooper NJ, Kendrick D, Achana F, Dhiman P, He Z, Wynn P, Le Cozannet E, Saramago P, Sutton AJ: Network meta-analysis to evaluate the effectiveness of interventions to increase the uptake of smoke alarms. Epidemiol Rev. 2012, 34: 32-45. 10.1093/epirev/mxr015.CrossRefPubMed
27.
Hayden JA, van Tulder MW, Tomlinson G: Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005, 142: 776-785. 10.7326/0003-4819-142-9-200505030-00014.CrossRefPubMed
28.
Welton NJ, Caldwell DM, Adamopoulos E, Vedhara K: Mixed treatment comparison meta-analysis of complex interventions: psychological interventions in coronary heart disease. Am J Epidemiol. 2009, 169: 1158-1165. 10.1093/aje/kwp014.CrossRefPubMed
29.
Dias S, Welton NJ, Caldwell DM, Ades AE: Checking consistency in mixed treatment comparison meta-analysis. Stat Med. 2010, 29: 932-944. 10.1002/sim.3767.CrossRefPubMed
30.
Salanti G, Ades AE, Ioannidis JP: Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial. J Clin Epidemiol. 2011, 64: 163-171. 10.1016/j.jclinepi.2010.03.016.CrossRefPubMed
31.
Nixon RM, Bansback N, Brennan A: Using mixed treatment comparisons and meta-regression to perform indirect comparisons to estimate the efficacy of biologic treatments in rheumatoid arthritis. Stat Med. 2007, 26: 1237-1254. 10.1002/sim.2624.CrossRefPubMed
32.
Carpenter J, Rucker G, Schwarzer G: Assessing the sensitivity of meta-analysis to selection bias: a multiple imputation approach. Biometrics. 2011, 67: 1066-1072. 10.1111/j.1541-0420.2010.01498.x.CrossRefPubMed
Metadata
Title
Efficacy of falls prevention interventions: protocol for a systematic review and network meta-analysis
Authors
Andrea C Tricco
Elise Cogo
Jayna Holroyd-Leduc
Kathryn M Sibley
Fabio Feldman
Gillian Kerr
Sumit R Majumdar
Susan Jaglal
Sharon E Straus
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2013
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/2046-4053-2-38

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