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Fall prevention programmes should be encouraged after treatment for a fall, researchers say

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Older people who go to hospital after having a fall are not likely to participate in a fall prevention programme after being discharged, even if they are given information about local programmes, according to a new study.

Researchers at Boston Medical Center investigated fall prevention activities, including interactions with primary care providers, among older adults who were discharged home after visiting the accident & emergency department with a fall-related injury.

The study — published in the journal Injury Epidemiology — highlights the challenges of effectively helping these patients prevent future falls, as well as the importance of educating both patients and providers about available programmes designed to help prevent falls in the future.

Out of 87 patients enrolled in the study who were provided with a flyer for a ‘Matter of Balance’ course and were interviewed 60 days after their initial hospital visit, 37% reported engaging in fall prevention activities but none took part in a fall prevention programme.

The research also revealed that 14% of the participants fell again after they were discharged, and 8% returned to the emergency department for treatment.

“For older adults that fall, that first emergency department visit is an important, but underutilised opportunity to mobilise healthcare resources for people at a high risk for subsequent falls,” explained Dr Kalpana Narayan Shankar, an emergency medicine physician at Boston Medical Center and corresponding author of the study.

While patients did not enroll in a prevention programme, many reported discussing their falls with others before the study’s follow-up call two months later. In all, 71% of patients spoke with a healthcare provider about their fall, 37% talked to those providers specifically about ways to reduce falls, and 46% and 36% percent talked to family members or friends, respectively, about what they can do to prevent falls.

“The amount of dialogue patients reported having about their falls is encouraging, but their fall should trigger a more significant health system response to lessen their risk of future falls,” Dr Narayan said. “This is difficult to accomplish solely in the emergency department due to time and resource constraints.”

Dr Narayan stressed that both providers and patients need more education on the effectiveness of clinical and community fall prevention interventions and activities and the fact that they can be an important part of preventing future falls.

https://www.bmc.org/news/press-releases/2017/08/08/one-fall-too-many

https://injepijournal.springeropen.com/articles/10.1186/s40621-017-0114-y