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Multifactor Program Does Not Cut Serious Fall Injuries in Elderly

THURSDAY, July 9, 2020 -- A nurse-administered multifactorial intervention does not result in a significantly lower rate of first adjudicated serious fall injury among older adults at increased risk for fall injuries, according to a study published in the July 9 issue of the New England Journal of Medicine.

Shalender Bhasin, M.B., B.S., from Brigham and Women's Hospital in Boston, and colleagues examined the effectiveness of a multifactorial intervention administered by specially trained nurses, including risk assessment and individualized plans, to prevent fall injuries among community-dwelling adults aged 70 years and older. Eighty-six primary care practices were randomly assigned to the intervention or to enhanced usual care (43 each).

The researchers found that demographic and baseline characteristics were similar for the intervention group (2,802 adults) and the control group (2,649 adults). There was no significant difference noted between the groups in the rate of a first adjudicated serious fall injury as assessed in a time-to-first-event analysis (events per 100 person-years of follow-up, 4.9 and 5.3 in the intervention and control groups, respectively; hazard ratio, 0.92; 95 percent confidence interval, 0.80 to 1.06; P = 0.25). In the intervention and control groups, the rate of a first participant-reported fall injury was 25.6 and 28.6 events per 100 person-years of follow-up, respectively (hazard ratio, 0.90; 95 percent confidence interval, 0.83 to 0.99; P = 0.004).

"Our finding that the multifactorial intervention was not significantly more effective than enhanced usual care in reducing serious fall injuries was unexpected, since previous efficacy trials have shown benefit with respect to individual components of the intervention," the authors write.

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Posted: July 2020