Can health visitors prevent fractures in elderly people?
OBJECTIVE
To assess whether intervention by a health visitor could reduce the number of fractures, over a four year period, in those aged 70 and over.


METHODS
Randomised, controlled trial; randomisation by household.


METHODS
General practice in a market town.


METHODS
Of 863 patients aged 70 and over on the practice records, 674 were traced and successfully interviewed; 350 were assigned to the intervention group, 324 as controls.


METHODS
The people in the intervention group were allocated to the care of a health visitor. The approach was four pronged: assessment and correction of nutritional deficiencies, including reducing smoking and alcohol intake; assessment and referral of medical conditions such as heart block or inappropriate medication; assessment and correction of environmental hazards in the home such as poor lighting; assessment and improvement of fitness--for example, exercise classes for the moderately fit. The intervention continued for four years.


METHODS
Fracture rate over four years.


RESULTS
The incidence of fractures was 5% (16/350) in the intervention group and 4% (14/324) in the control group (difference not significant).


CONCLUSIONS
A health visitor visiting a group of people aged 70 and over and using simple preventive measures had no effect on the incidence of fractures.
Vetter
N J
NJ
University of Wales College of Medicine, Cardiff.
Lewis
P A
PA
Ford
D
D
D000368:Aged; D000428:Alcohol Drinking / Q000517:prevention & control; D003152:Community Health Nursing; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control*; D006798:Housing; D006801:Humans; D008297:Male; D009748:Nutrition Disorders / Q000517:prevention & control; D010809:Physical Fitness; D000074606:Smoking Prevention