@article{ref1,
title="Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health-related quality of life",
journal="Journal of the American Geriatrics Society",
year="2022",
author="Ganz, David A. and Yuan, Anita H. and Greene, Erich J. and Latham, Nancy K. and Araujo, Katy and Siu, Albert L. and Magaziner, Jay and Gurwitz, Jerry H. and Wu, Albert W. and Alexander, Neil B. and Wallace, Robert B. and Greenspan, Susan L. and Rich, Jeremy and Volpi, Elena and Waring, Stephen C. and Dykes, Patricia C. and Ko, Fred and Resnick, Neil M. and McMahon, Siobhan K. and Basaria, Shehzad and Wang, Rixin and Lu, Charles and Esserman, Denise and Dziura, James and Miller, Michael E. and Travison, Thomas G. and Peduzzi, Peter and Bhasin, Shalender and Reuben, David B. and Gill, Thomas M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Falls are common in older adults and can lead to severe injuries. The Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) trial cluster-randomized 86 primary care practices across 10 health systems to a multifactorial intervention to prevent fall injuries, delivered by registered nurses trained as falls care managers, or enhanced usual care. STRIDE enrolled 5451 community-dwelling older adults age ≥70 at increased fall injury risk. <br><br>METHODS: We assessed fall-related outcomes via telephone interviews of participants (or proxies) every 4 months. At baseline, 12 and 24 months, we assessed health-related quality of life (HRQOL) using the EQ-5D-5L and EQ-VAS. We used Poisson models to assess intervention effects on falls, fall-related fractures, fall injuries leading to hospital admission, and fall injuries leading to medical attention. We used hierarchical longitudinal linear models to assess HRQOL. <br><br>RESULTS: For recurrent event models, intervention versus control incidence rate ratios were 0.97 (95% confidence interval [CI], 0.93-1.00; p = 0.048) for falls, 0.93 (95% CI, 0.80-1.08; p = 0.337) for self-reported fractures, 0.89 (95% CI, 0.73-1.07; p = 0.205) for adjudicated fractures, 0.91 (95% CI, 0.77-1.07; p = 0.263) for falls leading to hospital admission, and 0.97 (95% CI, 0.89-1.06; p = 0.477) for falls leading to medical attention. Similar effect sizes (non-significant) were obtained for dichotomous outcomes (e.g., participants with ≥1 events). The difference in least square mean change over time in EQ-5D-5L (intervention minus control) was 0.009 (95% CI, -0.002 to 0.019; p = 0.106) at 12 months and 0.005 (95% CI, -0.006 to 0.015; p = 0.384) at 24 months. <br><br>CONCLUSIONS: Across a standard set of outcomes typically reported in fall prevention studies, we observed modest improvements, one of which was statistically significant. Future work should focus on patient-, practice-, and organization-level operational strategies to increase the real-world effectiveness of interventions, and improving the ability to detect small but potentially meaningful clinical effects. CLINICALTRIALS: gov identifier: NCT02475850.<p /> <p>Language: en</p>",
language="en",
issn="0002-8614",
doi="10.1111/jgs.17964",
url="http://dx.doi.org/10.1111/jgs.17964"
}