Development and preliminary examination of the predictive validity of the Falls Risk Assessment Tool (FRAT) for use in primary care.
BACKGROUND
There is no validated assessment of an older person's risk of falling that is easily applied in primary care. We aimed to develop a two-part tool for use in primary care or the community. Part 1 includes a rapid assessment of the individual's risk of falling for administration by clinical or non-clinical staff. Part 2 (for clinical staff) includes guidance on further assessment, referral and interventions. We assessed the predictive validity of part 1.


METHODS
The tool was developed by an expert panel following the updating of an existing systematic review of community-based prospective studies identifying risk factors for falling and modified in accordance with the feedback from extensive piloting. We assessed predictive validity by a questionnaire survey sent at baseline and 6 months to a random sample of 1000 people aged over 65 in one Primary Care Group area.


RESULTS
Five items were included in part 1: history of any fall in the previous year, four or more prescribed medications, diagnosis of stroke or Parkinson's disease, reported problems with balance, inability to rise from a chair without using arms. The presence of three or more risk factors had a positive predictive value for a fall in the next 6 months of 0.57 (95 per cent confidence interval 0.43-0.69). Less than three risk factors had a negative predictive value of 0.86 (0.82-0.89), and a specificity of 0.92 (0.88-0.94).


CONCLUSIONS
The tool may be useful for identifying people who would benefit from further assessment of their risk of falling and appropriate intervention.
Department of General Practice and Primary Care, Queen Mary's School of Medicine and Dentistry, London.
Sudip
S
Nandy
Suzanne
S
Parsons
Colin
C
Cryer
Martin
M
Underwood
Elaine
E
Rashbrook
Yvonne
Y
Carter
Sandra
S
Eldridge
Jacqueline
J
Close
Dawn
D
Skelton
Stephanie
S
Taylor
Gene
G
Feder
D000056:Accident Prevention / Q000379:methods; D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D033183:Interdisciplinary Communication; D016015:Logistic Models; D008297:Male; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom