Clinical trial NCT00463658: Interdisciplinary Falls Prevention for Seniors
Official title: The Comparative Effects and Expenses of a Proactive Nurse-Led, Multifactorial and Interdisciplinary Team Approach to Falls Prevention for Older At-Risk Home Care Clients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Injuries
Keywords: Falls
Home Care
Aging Population
Clinical Effectiveness
Health Economics
Lead sponsor: McMaster University
Sponsor class: OTHER
Collaborators: name: Canadian Patient Safety Institute
name: Mississauga Halton Community Care Access Centre
name: Hamilton Niagara Haldimand Brant Community Care Access Centre
name: Ontario Ministry of Health and Long Term Care
name: Halton Region Health Department
name: Community Rehab
First posted: 2007-04-20
Enrollment: 109
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: With an aging population, an associated increase in the number of falls and fall injuries, there is a need to examine how health care services, such as home care, can best prevent falls among older people. This project will directly address this area by evaluating the effects and expense of an innovative approach to home care service delivery for older people at-risk for falls.

Detailed description: Falls and fall injuries are common-potentially preventable-causes of mortality, morbidity, functional decline, and increased health-care use and cost among community-living seniors over 75 years of age.

The knowledge gained from this project will directly address the Canadian Patient Safety Institute's priority areas for research in the Applied Health Services Research Stream by evaluating an innovative approach to reducing adverse events in a community-based (home care) setting.

The project will also identify the prevalence, determinants and costs of falls and fall injuries among older people requiring home care services. The design will be a two-armed; single blind randomized controlled trial of 110 older people 75 years and over, at risk for falls receiving hom care in Ontario. Subjects will be randomly allocated to either usual home care (control) or the interdisciplinary team. In the interdisciplinary group, a team of professional home care service providers, with specialized training in falls prevention, will proactively provide a comprehensive, coordinated and evidence based approach to falls prevention. The results will inform policies and practice related to the allocation and delivery of home care services for falls prevention across Canada.

Eligibility criteria: Inclusion Criteria:

* Must be English speaking
* 75 years of age and over
* Newly referred to and eligible for personal support services
* Living at home in the community
* Identified as being at risk for falls

Exclusion Criteria:

* Refusal to give informed consent
* Unable to read/write English and a translator is not available

Primary outcomes:
measure: Number of self-reported falls: Falls surveillance report
timeFrame: 10 minutes
Secondary outcomes:
measure: Health-Related Quality of Life and Function: SF-36 Health Survey
timeFrame: 15-20 minutes
measure: Gait and Balance: Performance-Oriented Mobility Assessment
timeFrame: 10 minutes
measure: Depression: Centre for Epidemiological Studies in Depression Scale
timeFrame: 5-10 minutes
measure: Standardized Mini Mental State Examination
timeFrame: 20-25 minutes
measure: Confidence in Performing Activities of Daily Living: Modified Falls Efficacy Scale
timeFrame: 5-10 minutes
measure: Nutritional risk: Screen II Questionnaire
timeFrame: 10-15 minutes
measure: Cost of Use of Health Services: Health and Social Services Utilization Questionnaire
timeFrame: 20 minutes
measure: Caregiver burden: Caregiver Strain Index
timeFrame: 5-10 minutes
Other outcomes:
Locations:
city: Hamilton
country: Canada
facility: McMaster University - Faculty of Health Sciences at Frid
state: Ontario
Study officials:
affiliation: School of Nursing, McMaster University
name: Maureen Markle-Reid, RN MScN PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Isaranuwatchai W, Perdrizet J, Markle-Reid M, Hoch JS. Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling. BMC Geriatr. 2017 Sep 1;17(1):199. doi: 10.1186/s12877-017-0599-9.
citation: Markle-Reid M, Browne G, Gafni A, Roberts J, Weir R, Thabane L, Miles M, Vaitonis V, Hecimovich C, Baxter P, Henderson S. The effects and costs of a multifactorial and interdisciplinary team approach to falls prevention for older home care clients 'at risk' for falling: a randomized controlled trial. Can J Aging. 2010 Mar;29(1):139-61. doi: 10.1017/S0714980809990377.
citation: Markle-Reid M, Browne G, Gafni A, Roberts J, Weir R, Thabane L, Miles M, Vaitonis V, Hecimovich C, Baxter P, Henderson S. A cross-sectional study of the prevalence, correlates, and costs of falls in older home care clients 'at risk' for falling. Can J Aging. 2010 Mar;29(1):119-37. doi: 10.1017/S0714980809990365.