TY  - JOUR
PY  - 2023//
TI  - A multicomponent primary-care intervention for preventing falls in older adults living in the community: the PREMIO study
JO  - Journal of clinical medicine
A1  - Marrocco, Walter
A1  - Galli, Antonella
A1  - Scotti, Silvestro
A1  - Calabrese, Nicola
A1  - Misericordia, Paolo
A1  - Dalle Vedove, Alessandro
A1  - Marrocco, Gianmarco
A1  - D'Ingianna, Antonio Pio
A1  - Pizzini, Andrea
A1  - Fini, Massimo
A1  - Tomino, Carlo
A1  - Bonassi, Stefano
A1  - Group, On Behalf Of The F. I. M. M. G. Research Premio
SP  - e7134
EP  - e7134
VL  - 12
IS  - 22
N2  - BACKGROUND: Falls are a common cause of morbidity and functional impairment in the elderly and represent a significant health problem. General practitioners (GPs) are the first point of contact for health issues and may provide preventive services. The randomized clinical trial PREMIO was conducted by GPs to evaluate the effects of a multicomponent intervention for the prevention of falls in older adults aged ≥ 65 years at high risk of falling. <br><br>METHODS: 117 GPs enrolled 1757 patients (1116 F, 641 M) and randomized them into 2 groups (intervention and control). The intervention group received medical and behavioral counseling, home risk-factor assessment, a physical-activity program and nutritional counseling. The control group received only the nutritional counseling. Both groups were followed for one year. The primary outcome was the rate of falls at home over 12 months. <br><br>RESULTS: 1225 patients completed the study. Subjects receiving the intervention had, on average, fewer falls at home (percentage change -31.2%, p < 0.02) and fewer total falls (-26.0%, p < 0.02), although the reduction in the number of fallers was small (-3.9%, p = 0.05). Among the secondary endpoints, rates of general hospital or emergency-department admission and GP visits showed slight improvements (not statistically significant), while the risk of fractures was unexpectedly increased in the intervention group compared to the controls (odds ratio 2.39, p = 0.023). <br><br>CONCLUSIONS: Future studies and public-health interventions to prevent domestic falls among community-dwelling older people at high risk of falling could benefit from a multicomponent approach including medication review, physical exercise and home risk assessment and should include assessment of risk factors for fractures.<p />  <p>Language: en</p>
LA  - en
SN  - 2077-0383
UR  - http://dx.doi.org/10.3390/jcm12227134
ID  - ref1
ER  -