PCORI has identified fall prevention as an important research topic. Patients, clinicians, and others want to learn how doctors can help older patients prevent falls. PCORI partnered with the National Institute on Aging in 2013 to fund a large-scale research study on this topic called the Clinical Trial of a Multifactorial Fall Injury Prevention Strategy in Older Persons.
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Falls are a common problem for older adults. They can lead to serious injury, disability, and even death. Nearly one in three people over the age of 65 fall each year. Even more people over the age of 75 fall.
For this study, researchers worked with patients, caregivers, and healthcare providers to come up with a fall prevention plan that is based on results from past studies. The plan focuses on the things patients care about most, such as avoiding falls or injury from a fall. The plan also takes into account many things in patients’ lives that can affect their risk of falling. Doctors need help to make screening and planning related to falls a regular part of visits with older patients. To that end, the plan also includes extra training for doctors.
Researchers are comparing two ways to help prevent falls among older adults who live at home:
- Giving patients general information about preventing falls
- Working with a nurse who is a fall care manager to develop and follow a plan to prevent falls, considering each patient’s risk factors
Who can this research help?
This research can help doctors choose how to help older patients prevent falls.
What is the research team doing?
The research team is enrolling 5,400 patients from 86 primary care practices in 10 healthcare systems. Researchers are screening patients at these practices to find out if they are at high risk for falls. Researchers are assigning the practices to one of two groups by chance. In one group, consisting of 43 primary care practices, patients receive regular care. This includes giving patients information about how to prevent falls. In the other group, a specially trained nurse identifies each patient’s risk factors for fall injuries. The nurse works with each patient and their primary care doctor to create a plan to reduce the patient’s chance of falling. The plan also includes treatment for other health problems that may make the patient more likely to be hurt badly if they fall. The research team is working with healthcare providers and staff at this group of clinics to help make this kind of care a routine part of visits with older patients.
The research team is following up with patients for up to 40 months after they join the study. The research team is talking with patients during follow-up telephone interviews and looking at patients’ medical records to find out:
- If patients have had fewer severe injuries because of a fall
- If patients have fallen but haven’t been injured
- How confident patients feel about being able to prevent falls
- How well patients are able to do normal daily tasks
- Whether patients feel anxious or depressed
During the first year of the project, the research team and a group of patients, caregivers, and healthcare providers are testing the program and fixing any problems that they find. They are also reviewing the project midway to look at early results and make any necessary corrections. The researchers and their partners are working together to decide how hard or easy it will be to teach doctors in other clinics to use this process.
Research methods at a glance
|Study Design||Randomized controlled trial|
Adults at least 70 years old who meet any of 3 criteria:
Primary: Serious fall injuries
Secondary: All falls with injuries, all falls, indicators of well-being
|40-month follow-up for all outcomes except indicators of well-being, for which the follow-up is 24 months|
|Results Highlights: In a paper in the New England Journal of Medicine, this study reported that having nurses tailor and administer fall-prevention plans for older adults at high risk resulted in about an 8 percent to 10 percent reduction in serious fall injuries, but this effect was not statistically significant. The paper discusses potential barriers to care and other factors that could account for why a more significant reduction in serious fall injuries was not seen when risk-reduction strategies shown to be effective in previous studies were deployed this way in real-world circumstances and settings.|
Results of This Project
Other Clinical Interventions
Other Health Services Interventions
Training and Education Interventions