A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT).
OBJECTIVE
to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients.


METHODS
cluster-randomised controlled 12-month trial.


METHODS
psychogeriatric wards in 12 nursing homes in The Netherlands.


METHODS
psychogeriatric nursing home patients (n = 518).


METHODS
a general medical assessment and an additional specific fall risk evaluation tool, applied by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities.


METHODS
falls.


RESULTS
there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward-related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43-0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme.


CONCLUSIONS
the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduces the number of falls. This reduction is substantial and of high clinical relevance.
Neyens
Jacques C L
JC
Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200MD, The Netherlands. j.neyens@zw
Dijcks
Béatrice P J
BP
Twisk
Jos
J
Schols
Jos M G A
JM
van Haastregt
Jolanda C M
JC
van den Heuvel
Wim J A
WJ
de Witte
Luc P
LP
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000368:Aged; D005500:Follow-Up Studies; D005851:Geriatric Nursing; D005852:Geriatric Psychiatry; D006801:Humans; D015994:Incidence; D008134:Long-Term Care / Q000706:statistics & numerical data; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D009788:Occupational Therapy; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D012307:Risk Factors; D016896:Treatment Outcome