title: A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls.
abstract: OBJECTIVE
  to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process.
  
  
  METHODS
  multicentre randomised controlled trial.
  
  
  METHODS
  eight general practices and three day hospitals based in the East Midlands, UK.
  
  
  METHODS
  three hundred and sixty-four participants, mean age 79 years, with a median of three falls risk factors per person at baseline.
  
  
  METHODS
  a day hospital-delivered multifactorial falls prevention programme, consisting of strength and balance training, a medical review and a home hazards assessment.
  
  
  METHODS
  rate of falls over 12 months of follow-up, recorded using self-completed monthly diaries.
  
  
  RESULTS
  one hundred and seventy-two participants in each arm contributed to the primary outcome analysis. The overall falls rate during follow-up was 1.7 falls per person-year in the intervention arm compared with 2.0 falls per person-year in the control arm. The stratum-adjusted incidence rate ratio was 0.86 (95% CI 0.73-1.01), P = 0.08, and 0.73 (95% CI 0.51-1.03), P = 0.07 when adjusted for baseline characteristics. There were no significant differences between the intervention and control arms in any secondary outcomes.
  
  
  CONCLUSIONS
  this trial did not conclusively demonstrate the benefit of a day hospital-delivered multifactorial falls prevention programme, in a population of older people identified as being at high risk of a future fall.
authors.affiliation: spc3@le.ac.uk
authors.forename: Simon
authors.initials: S
authors.lastname: Conroy
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
authors.forename: Rowan
authors.initials: R
authors.lastname: Harwood
authors.forename: John
authors.initials: J
authors.lastname: Gladman
authors.forename: Carol
authors.initials: C
authors.lastname: Coupland
authors.forename: Tracey
authors.initials: T
authors.lastname: Sach
authors.forename: Avril
authors.initials: A
authors.lastname: Drummond
authors.forename: Jane
authors.initials: J
authors.lastname: Youde
authors.forename: Judi
authors.initials: J
authors.lastname: Edmans
authors.forename: Tahir
authors.initials: T
authors.lastname: Masud
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003631:Day Care, Medical / Q000458:organization & administration* / Q000706:statistics & numerical data; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D016852:Housing for the Elderly / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening; D053580:Muscle Strength; D004856:Postural Balance; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D016896:Treatment Outcome
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