Di Monaco M, De Toma E, Gardin LD, Giordano S, Castiglioni C, Vallero F. Eur. J. Phys. Rehabil. Med. 2014; 51(1): 15-22.
Affiliation
Osteoporosis Research Center, Division of Physical Medicine and Rehabilitation, PresidioSanitario San Camillo, Torino - marco.di.monaco@alice.it,medici@h--sancamillo.to.it.
BACKGROUND: Post--discharge telephone calls to reinforce targeted recommendations for fall prevention have scarcely been investigated in hip--fracture survivors. Aim. To assess the effectiveness of a single telephone call by an occupational therapist in reducing the proportion of fallers (primary endpoint) and improving the adherence to targeted recommendations for fall prevention (secondary endpoint) after hospital discharge in hip--fracture women.
DESIGN: Randomized controlled trial. SETTING: Post--acute rehabilitation hospital and community (post--discharge). POPULATION: We randomized 169 of 228 women with a fall--related fracture of the hip. Data for analyses were available for 153 women (78 from the intervention group and 75 controls).
METHODS: All the women underwent a multidisciplinary program targeted at fall prevention during post--acute inpatient rehabilitation. Additionally, the intervention group received a telephone call by an occupational therapist to reinforce the targeted recommendations for fall prevention at a median of 18 days after discharge. The outcomes were assessed at a six--month follow--up.
RESULTS. Eleven of the 78 women (14.1%) from the intervention group, and 10 of the 75 (13.3%) from the controls sustained at least one fall during the follow--up (relative risk = 1.06; 95% CI from 0.48 to 2.34). The mean adherence to the recommendations for fall prevention was 75.1% in the intervention group and 71.2% in the controls (between group difference 3.9; 95% CI from --3.4 to 11.3; p=0.29).
CONCLUSION: Our study does not support a post--discharge telephone call to reinforce the recommendations for fall prevention in hip--fracture women. CLINICAL REHABILITATION IMPACT: We contribute to elucidate one aspect of multidisciplinary fall--prevention strategies in hip--fracture survivors.