There is little evidence that fall prevention programmes used throughout the NHS are effective in cutting the number of fallers or fall-related injuries, finds a study published on bmj.com today.
Falls are a major health problem for older adults. In the UK, both the National Service Framework for Older People and the National Institute for Health and Clinical Excellence (NICE) recommend multifactorial fall prevention programmes as an effective way to reduce falls. Such services (falls clinics) have now been introduced throughout the NHS.
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Researchers at the Universities of Warwick and Oxford reviewed 19 trials involving 6,397 participants that assessed multiple risk factors for falling and provision of treatments to address these risk factors. The quality of the trials was variable.
They found no strong evidence of benefit from this type of intervention. There was no clear reduction in the number of people having at least one fall, the number having fall-related injuries or use of health services (attendance at an emergency department or admission to hospital).
Interventions that actively provide treatments may be more effective than those that provide only knowledge and referral, but this remains uncertain, say the authors.
This review included more trials and more participants than earlier reviews, they say, and found little evidence that multifactorial fall prevention programmes are effective in reducing the number of fallers or fall-related injuries.
There is an urgent need for a large scale definitive evaluation to assess clinical and cost-effectiveness of this type of intervention, they conclude.
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