Educational intervention to reduce falls and fear of falling in patients after fragility fracture: results of a controlled pilot study.
OBJECTIVE
Falls and fear of falling are a major health problem. We sought to determine the effectiveness of an educational intervention in reducing fear of falling and preventing recurrent falls in community-dwelling patients after a fragility fracture.


METHODS
One hundred two community-dwelling patients aged 50 years or older who fell and sustained a wrist fracture and were treated at Emergency Departments in Edmonton, Alberta, Canada (2001-2002) were allocated to either standardized educational leaflets and post-discharge telephone counseling regarding fall prevention strategies ("intervention") or attention-controls ("controls"). Main outcomes were fear of falling and recurrent falls 3 months after fracture.


RESULTS
Mean age was 67 years and most patients were female (80%). The majority of falls (76%) leading to fracture occurred outdoors. Three months post-fracture, almost half of patients (48%) reported increased fear of falling and 11 of 102 (11%) reported falling again. The intervention did not reduce the fear of falling (43% had increased fear vs. 53% of controls, adjusted P value=0.55) or decrease recurrent falls (17% fell vs. 5% of controls, adjusted P value=0.059) within 3 months of fracture.


CONCLUSIONS
An educational intervention undertaken in the Emergency Department was no more effective than usual care in reducing fear of falling or recurrent falls in community-dwelling patients. Future strategies must address a number of dimensions beyond simple education.
Rucker
Diana
D
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Rowe
Brian H
BH
Johnson
Jeffrey A
JA
Steiner
Ivan P
IP
Russell
Anthony S
AS
Hanley
David A
DA
Maksymowych
Walter P
WP
Holroyd
Brian R
BR
Harley
Charles H
CH
Morrish
Donald W
DW
Wirzba
Brian J
BJ
Majumdar
Sumit R
SR
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D005239:Fear / Q000523:psychology*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D016330:Frail Elderly / Q000523:psychology*; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016730:Program Development; D012008:Recurrence; D014954:Wrist Injuries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology