The design and development of a complex multifactorial falls assessment intervention for falls prevention: The Prevention of Falls Injury Trial (PreFIT)

BMC Geriatrics

Research Article

John Davison¹  Finbarr C. Martin²  Shvaita Ralhan³  Ray Sheridan⁴  Katharine Westacott⁵  Julie Bruce⁶  Susanne Finnegan⁶  Emma Withers⁶  Sarah E. Lamb⁷ 

[1] Falls and Syncope Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, NE1 4LP, Newcastle, UK;Guys and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, SE1 7EH, London, UK;Oxford University Hospitals NHS Trust, The John Radcliffe Hospital, Headley Way, Headington, OX3 9DU, Oxfordshire, UK;Royal Devon & Exeter Hospital, Barrack Road, EX2 5DW, Exeter, UK;University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, CV2 2DX, Coventry, UK;Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, CV4 7AL, Coventry, UK;Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, CV4 7AL, Coventry, UK;Botnar Research Centre, Nuffield Department of Orthopaedics Rheumatology & Musculoskeletal Sciences, University of Oxford, Windmill Road, OX3 7LD, Oxford, UK;

关键词: Falls;    Falls prevention;    Multifactorial assessment;    Older adults;    Trial intervention;   

DOI  :  10.1186/s12877-017-0492-6

 received in 2016-06-24, accepted in 2017-04-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis paper describes the design and development of a complex multifactorial falls prevention (MFFP) intervention for implementation and testing within the framework of a large UK-based falls prevention randomised controlled trial (RCT).MethodsA complex intervention was developed for inclusion within the Prevention of Falls Injury Trial (PreFIT), a multicentre pragmatic RCT. PreFIT aims to compare the clinical and cost-effectiveness of three alternative primary care falls prevention interventions (advice, exercise and MFFP), on outcomes of fractures and falls. Community-dwelling adults, aged 70 years and older, were recruited from primary care in the National Health Service (NHS), England.ResultsDevelopment of the PreFIT MFFP intervention was informed by the existing evidence base and clinical guidelines for the assessment and management of falls in older adults. After piloting and modification, the final MFFP intervention includes seven falls risk factors: a detailed falls history interview with consideration of ‘red flags’; assessment of balance and gait; vision; medication screen; cardiac screen; feet and footwear screen and home environment assessment. This complex intervention has been fully manualised with clear, documented assessment and treatment pathways for each risk factor. Each risk factor is assessed in every trial participant referred for MFFP. Referral for assessment is based upon a screening survey to identify those with a history of falling or balance problems. Intervention delivery can be adapted to the local setting.ConclusionThis complex falls prevention intervention is currently being tested within the framework of a large clinical trial. This paper adheres to TIDieR and CONSORT recommendations for the comprehensive and explicit reporting of trial interventions. Results from the PreFIT study will be published in due course. The effectiveness and cost-effectiveness of the PreFIT MFFP intervention, compared to advice and exercise, on the prevention of falls and fractures, will be reported at the conclusion of the trial.

【 授权许可】

CC BY   
© The Author(s). 2017