TY  - JOUR
PY  - 2023//
TI  - Pragmatic multicentre stepped-wedge cluster randomised trial to investigate the effectiveness of community-based falls prevention programme for older adults with falls risk in Singapore: a protocol paper
JO  - BMJ open
A1  - Tan, Pey June
A1  - Ginting, Mimaika Luluina
A1  - Lim, Zoe Zon Be
A1  - Balachandar, Nivedha
A1  - Sultana, Rehena
A1  - Kadir, Mumtaz Mohamed
A1  - Xu, Tianma
A1  - Ismail, Noor Hafizah
A1  - Yap, Joyce Kwee Yong
A1  - Wong, Sweet Fun
A1  - Yoong, Joanne
A1  - Matchar, David Bruce
A1  - Hill, Keith
A1  - Wong, Chek Hooi
SP  - e072029
EP  - e072029
VL  - 13
IS  - 6
N2  - INTRODUCTION: Falls are an important public health issue with consequences that include injuries, quality of life reduction and high healthcare costs. Studies show that falls prevention strategies are effective in reducing falls rate among community-dwelling older adults. However, the evaluation for effectiveness was usually done in a controlled setting with homogeneous population, and thus may not be generalisable to a wider population. This study aims to evaluate the impact of community falls prevention programmes with group-based strength and balance exercises, on falls risk and health outcomes for older adults with falls risk in Singapore. <br><br>METHODS AND ANALYSIS: This is a pragmatic closed cohort stepped-wedge cluster randomised trial design study, which involves sequential crossover of clusters from the waitlist control condition to the intervention condition, with the sequence of crossover randomly determined. The intervention will be sequentially rolled out to 12 clusters (a minimum of 5 participants/cluster), over 6 time periods with 8-week intervals in Central and North regions of Singapore. The primary analysis will be conducted under the intention-to-treat principle. A general linear mixed model or generalised estimating equation analysis appropriate for a multilevel longitudinal study incorporating an appropriate error distribution and link function will be used. Markov model will be developed to estimate the incremental cost per quality-adjusted life years and incremental cost per fall prevented from the implementation of falls prevention strategies from a societal perspective. Conditional on there being clinically relevant differences in short-term outcomes, we will implement simulation modelling to project the long-term divergence in trajectories for outcomes and costs using the Markov model. ETHICS AND DISSEMINATION: Ethics approval has been obtained. <br><br>RESULTS will be disseminated in publications and other relevant platforms. TRIAL REGISTRATION NUMBER: NCT04788251.<p />  <p>Language: en</p>
LA  - en
SN  - 2044-6055
UR  - http://dx.doi.org/10.1136/bmjopen-2023-072029
ID  - ref1
ER  -