title: Patient education to prevent falls among older hospital inpatients: a randomized controlled trial.
abstract: BACKGROUND
  Falls are a common adverse event during hospitalization of older adults, and few interventions have been shown to prevent them.
  
  
  METHODS
  This study was a 3-group randomized trial to evaluate the efficacy of 2 forms of multimedia patient education compared with usual care for the prevention of in-hospital falls. Older hospital patients (n = 1206) admitted to a mixture of acute (orthopedic, respiratory, and medical) and subacute (geriatric and neurorehabilitation) hospital wards at 2 Australian hospitals were recruited between January 2008 and April 2009. The interventions were a multimedia patient education program based on the health-belief model combined with trained health professional follow-up (complete program), multi-media patient education materials alone (materials only), and usual care (control). Falls data were collected by blinded research assistants by reviewing hospital incident reports, hand searching medical records, and conducting weekly patient interviews.
  
  
  RESULTS
  Rates of falls per 1000 patient-days did not differ significantly between groups (control, 9.27; materials only, 8.61; and complete program, 7.63). However, there was a significant interaction between the intervention and presence of cognitive impairment. Falls were less frequent among cognitively intact patients in the complete program group (4.01 per 1000 patient-days) than among cognitively intact patients in the materials-only group (8.18 per 1000 patient-days) (adjusted hazard ratio, 0.51; 95% confidence interval, 0.28-0.93]) and control group (8.72 per 1000 patient-days) (adjusted hazard ratio, 0.43; 95% confidence interval, 0.24-0.78).
  
  
  CONCLUSIONS
  Multimedia patient education with trained health professional follow-up reduced falls among patients with intact cognitive function admitted to a range of hospital wards. Trial Registration anzctr.org.au Identifier: ACTRN12608000015347.
authors.affiliation: Allied Health Clinical Research Unit, Physiotherapy Department, Monash University and Southern Health, Kingston Centre, Kingston Road, Cheltenham, Victoria 3192, Australia. terrence.haines@med.monash.edu.au
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hill
authors.forename: Keith D
authors.initials: KD
authors.lastname: Hill
authors.forename: Steven
authors.initials: S
authors.lastname: McPhail
authors.forename: David
authors.initials: D
authors.lastname: Oliver
authors.forename: Sandra
authors.initials: S
authors.lastname: Brauer
authors.forename: Tammy
authors.initials: T
authors.lastname: Hoffmann
authors.forename: Christopher
authors.initials: C
authors.lastname: Beer
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D006801:Humans; D007297:Inpatients / Q000193:education*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D016896:Treatment Outcome