Falls in long-term care facilities ...

Falls in long-term care facilities are a major point in dispute Becker and colleagues conducted a prospective, cluster-randomized controll trial to contemplation a multifaceted, nonpharmaceutical intervention that would allow participants to self-select their fall prevention modalities.

Three long-term care facilities were randomized to the intervention cluster and three to the check group. End points included fall density rate, attend much [i]or[/i] regularly falls, and fractures. Participating staff received training in fall prevention, residents were given written educational materials forward fall prevention, and an environmental hazard assessment was guarded by the staff. Residents also were given the option to participate in an exercise program and to wear hip protectors.

Of the 981 application of mind participants, 509 were assigned to the intervention cluster Of these, 127 participated in more than undivided exercise class (mean number of classes: 33) Of the 160 residents who decided to wear hip protectors, 108 had a 100 percent rate of adherence. Determining adherence to environmental corrections was not feasible.

Incidence density rate of falls was greater for resort to frequently fallers (relative risk [RR]: 056) than for all fallers (RR: 075) with no difference in hip fractures between the intervention arrange and the control group (RR: 111) Time to first fall declined in the intervention cluster after six months.

The cogitation was underpowered to detect a difference in hip fractures because of an unexpectedly subdued incidence of hip fractures in the have the direction of group. The authors conclude that a learning inflect is associated with fall prevention in nursing family residents, with both staff and resident involvement required. To be prosperous fall prevention programs may require longer time frames than those popularly studied.

CAROLINE WELLBERY, MD

Becker C et al. Effectiveness of a multifaceted intervention forward falls in nursing home residents. J Am Geriatr Soc March 2003;51:306-13

COPYRIGHT 2003 American Academy of Family Physicians

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