Falls Assessment Clinical Trial (FACT): design, interventions, recruitment strategies and participant characteristics.
BACKGROUND
Guidelines recommend multifactorial intervention programmes to prevent falls in older adults but there are few randomised controlled trials in a real life health care setting. We describe the rationale, intervention, study design, recruitment strategies and baseline characteristics of participants in a randomised controlled trial of a multifactorial falls prevention programme in primary health care.


METHODS
Participants are patients from 19 primary care practices in Hutt Valley, New Zealand aged 75 years and over who have fallen in the past year and live independently. Two recruitment strategies were used - waiting room screening and practice mail-out. Intervention participants receive a community based nurse assessment of falls and fracture risk factors, home hazards, referral to appropriate community interventions, and strength and balance exercise programme. Control participants receive usual care and social visits. Outcome measures include number of falls and injuries over 12 months, balance, strength, falls efficacy, activities of daily living, quality of life, and physical activity levels.


RESULTS
312 participants were recruited (69% women). Of those who had fallen, 58% of people screened in the practice waiting rooms and 40% when screened by practice letter were willing to participate. Characteristics of participants recruited using the two methods are similar (p > 0.05). Mean age of all participants was 81 years (SD 5). On average participants have 7 medical conditions, take 5.5 medications (29% on psychotropics) with a median of 2 falls (interquartile range 1, 3) in the previous year.


CONCLUSIONS
The two recruitment strategies and the community based intervention delivery were feasible and successful, identifying a high risk group with multiple falls. Recruitment in the waiting room gave higher response rates but was less efficient than practice mail-out. Testing the effectiveness of an evidence based intervention in a 'real life' setting is important.
Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. c.elley@auckland.ac.nz
C Raina
CR
Elley
M Clare
MC
Robertson
Ngaire M
NM
Kerse
Sue
S
Garrett
Eileen
E
McKinlay
Beverley
B
Lawton
Helen
H
Moriarty
A John
AJ
Campbell
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D009730:Nursing Assessment / Q000379:methods*; D010353:Patient Education as Topic; D018579:Patient Selection; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D012947:Social Work; D011795:Surveys and Questionnaires