A randomized controlled trial of a multifactorial falls prevention intervention for older fallers presenting to emergency departments

J Am Geriatr Soc. 2010 Dec;58(12):2265-74. doi: 10.1111/j.1532-5415.2010.03191.x.


Objectives: To investigate the effect of a referral-based targeted multifactorial falls prevention intervention on the occurrence of recurrent falls and injuries in older people presenting to an emergency department (ED) after a fall and discharged directly home from the ED.

Design: Randomized controlled trial. Assessors of outcomes were unaware of group allocation.

Setting: Seven EDs in metropolitan Melbourne, Australia.

Participants: Inclusion criteria were community dwelling, aged 60 and older, presenting to an ED after a fall, and discharged directly home. Exclusion criteria were unable to follow simple instructions or walk independently.

Intervention: Targeted referrals to existing community services and health promotion recommendations, based on the falls risk factors found in a baseline assessment.

Measurements: Primary outcome measures were falls and resultant injuries occurring over the 12-month follow-up period. Falls and injury data were collected using falls calendars supported by medical record reviews.

Results: Three hundred sixty-one participants were randomized to the standard care group and 351 to the intervention group. No significant difference was found between the two groups over the 12-month follow-up period in number of fallers (relative risk (RR)=1.11, 95% confidence interval (CI)=0.95-1.31] or number of participants sustaining an injury from a fall (RR=1.06, 95% CI=0.86-1.29).

Conclusion: This study does not support the use of a referral-based targeted multifactorial intervention program to reduce subsequent falls or fall injuries in older people who present to an ED after a fall.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Australia
  • Community Health Services*
  • Emergency Service, Hospital
  • Exercise*
  • Female
  • Follow-Up Studies
  • Frail Elderly
  • Health Promotion*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Care Team
  • Referral and Consultation*
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome
  • Wounds and Injuries / prevention & control*