A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT)

Age Ageing. 2009 Mar;38(2):194-9. doi: 10.1093/ageing/afn297.

Abstract

Objective: to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients.

Design: cluster-randomised controlled 12-month trial.

Setting: psychogeriatric wards in 12 nursing homes in The Netherlands.

Participants: psychogeriatric nursing home patients (n = 518).

Intervention: a general medical assessment and an additional specific fall risk evaluation tool, applied by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities.

Measurements: falls.

Results: there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward-related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43-0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme.

Conclusion: the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduces the number of falls. This reduction is substantial and of high clinical relevance.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data*
  • Aged
  • Follow-Up Studies
  • Geriatric Nursing
  • Geriatric Psychiatry*
  • Humans
  • Incidence
  • Long-Term Care / statistics & numerical data
  • Netherlands / epidemiology
  • Nursing Homes / statistics & numerical data*
  • Occupational Therapy
  • Patient Care Team*
  • Physical Therapy Modalities
  • Risk Factors
  • Treatment Outcome