[Show abstract][Hide abstract] ABSTRACT: Objective: To explore the feasibility of implementing and evaluating the Guide to Action Care Home fall prevention intervention.Design: Two-centre, cluster feasibility randomized controlled trial and process evaluation.Setting: Purposive sample of six diverse old age/learning disability, long stay care homes in Nottinghamshire, UK.Subjects: Residents aged over 50 years, who had fallen at least once in the past year, not bed-bound, hoist-dependent or terminally ill.Interventions: Intervention homes (n = 3) received Guide to Action Care Home fall prevention intervention training and support. Control homes (n = 3) received usual care.Outcomes: Recruitment, attrition, baseline and six-month outcome completion, contamination and intervention fidelity, compliance, tolerability, acceptance and impact.Results: A total of 81 of 145 (56%) care homes expressed participatory interest. Six of 22 letter respondent homes (27%) participated. The expected resident recruitment target was achieved by 76% (52/68).
[Show abstract][Hide abstract] ABSTRACT: we estimated the cost-effectiveness of a community falls prevention service compared with usual care from a National Health Service and personal social services perspective over the 12 month trial period.
a cost-effectiveness and cost utility analysis alongside a randomised controlled trial
community. Participants: people over 60 years of age living at home or in residential care who had fallen and called an emergency ambulance but were not taken to hospital. Interventions: referral to community fall prevention services or usual health and social care.
incremental cost per fall prevented and incremental cost per Quality-Adjusted Life Years (QALYs)
a total of 157 participants (82 interventions and 75 controls) were used to perform the economic evaluation. The mean difference in NHS and personal social service costs between the groups was £-1,551 per patient over 1 year (95% CI: £-5,932 to £2,829) comparing the intervention and control groups. The intervention patients experienced on average 5.34 fewer falls over 12 months (95% CI: -7.06 to -3.62). The mean difference in QALYs was 0.070 (95% CI: -0.010 to 0.150) in favour of the intervention group.
the community falls prevention service was estimated to be cost-effective in this high-risk group. Current Controlled Trials ISRCTN67535605. (controlled-trials.com).
Age and Ageing 06/2012; 41(5):635-41. DOI:10.1093/ageing/afs071 · 3.64 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Falls in older people resident within care home settings are common and serious, often resulting in injury and mortality. Yet there is no standardised approach within UK care homes to assessing the risk of falls for individuals or identifying risk factors relevant for that person. The Guide to Action for Falls Prevention Tool - Care Homes (GtACH) was developed with local care homes in Nottinghamshire. Ten care homes were selected to participate in the study, four withdrawing before data collection commenced. Fourteen care home staff across six care homes tested the tool for usability and found it quick (20 minutes) and easy to use, yet only 53% of the recommended interventions highlighted were completed. The GtACH needs further evaluation to test whether its use prompts actions which reduce the number of falls, and the barriers to these actions being taken.
British journal of community nursing 05/2012; 17(5):206-9. DOI:10.12968/bjcn.2012.17.5.206