TY  - JOUR
PY  - 2019//
TI  - Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: systematic review and meta-analysis
JO  - Injury prevention
A1  - Morello, Renata Teresa
A1  - Soh, Sze-Ee
A1  - Behm, Kate
A1  - Egan, Amy
A1  - Ayton, Darshini
A1  - Hill, Keith
A1  - Flicker, Leon
A1  - Etherton-Beer, Christopher D.
A1  - Arendts, Glenn
A1  - Waldron, Nicholas
A1  - Redfern, Julie
A1  - Haines, Terrence
A1  - Lowthian, Judy
A1  - Nyman, Samuel R.
A1  - Cameron, Peter
A1  - Fairhall, Nicola
A1  - Barker, Anna Lucia
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: To determine whether multifactorial falls prevention interventions are effective in preventing falls, fall injuries, emergency department (ED) re-presentations and hospital admissions in older adults presenting to the ED with a fall. <br><br>DESIGN: Systematic review and meta-analyses of randomised controlled trials (RCTs). DATA SOURCES: Four health-related electronic databases (Ovid MEDLINE, CINAHL, EMBASE, PEDro and The Cochrane Central Register of Controlled Trials) were searched (inception to June 2018). STUDY SELECTION: RCTs of multifactorial falls prevention interventions targeting community-dwelling older adults (≥60 years) presenting to the ED with a fall with quantitative data on at least one review outcome. DATA EXTRACTION: Two independent reviewers determined inclusion, assessed study quality and undertook data extraction, discrepancies resolved by a third. DATA SYNTHESIS: 12 studies involving 3986 participants, from six countries, were eligible for inclusion. Studies were of variable methodological quality. Multifactorial interventions were heterogeneous, though the majority included education, referral to healthcare services, home modifications, exercise and medication changes. Meta-analyses demonstrated no reduction in falls (rate ratio = 0.78; 95% CI: 0.58 to 1.05), number of fallers (risk ratio = 1.02; 95% CI: 0.88 to 1.18), rate of fractured neck of femur (risk ratio = 0.82; 95% CI: 0.53 to 1.25), fall-related ED presentations (rate ratio = 0.99; 95% CI: 0.84 to 1.16) or hospitalisations (rate ratio = 1.14; 95% CI: 0.69 to 1.89) with multifactorial falls prevention programmes. <br><br>CONCLUSIONS: There is insufficient evidence to support the use of multifactorial interventions to prevent falls or hospital utilisation in older people presenting to ED following a fall. Further research targeting this population group is required.<br><br>© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.<p />  <p>Language: en</p>
LA  - en
SN  - 1353-8047
UR  - http://dx.doi.org/10.1136/injuryprev-2019-043214
ID  - ref1
ER  -