TY  - JOUR
PY  - 2022//
TI  - Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health-related quality of life
JO  - Journal of the American Geriatrics Society
A1  - Ganz, David A.
A1  - Yuan, Anita H.
A1  - Greene, Erich J.
A1  - Latham, Nancy K.
A1  - Araujo, Katy
A1  - Siu, Albert L.
A1  - Magaziner, Jay
A1  - Gurwitz, Jerry H.
A1  - Wu, Albert W.
A1  - Alexander, Neil B.
A1  - Wallace, Robert B.
A1  - Greenspan, Susan L.
A1  - Rich, Jeremy
A1  - Volpi, Elena
A1  - Waring, Stephen C.
A1  - Dykes, Patricia C.
A1  - Ko, Fred
A1  - Resnick, Neil M.
A1  - McMahon, Siobhan K.
A1  - Basaria, Shehzad
A1  - Wang, Rixin
A1  - Lu, Charles
A1  - Esserman, Denise
A1  - Dziura, James
A1  - Miller, Michael E.
A1  - Travison, Thomas G.
A1  - Peduzzi, Peter
A1  - Bhasin, Shalender
A1  - Reuben, David B.
A1  - Gill, Thomas M.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0002-8614
UR  - http://dx.doi.org/10.1111/jgs.17964
ID  - ref1
ER  -