title: A randomized controlled trial of a multifactorial falls prevention intervention for older fallers presenting to emergency departments.
abstract: OBJECTIVE
  To investigate the effect of a referral-based targeted multifactorial falls prevention intervention on the occurrence of recurrent falls and injuries in older people presenting to an emergency department (ED) after a fall and discharged directly home from the ED.
  
  
  METHODS
  Randomized controlled trial. Assessors of outcomes were unaware of group allocation.
  
  
  METHODS
  Seven EDs in metropolitan Melbourne, Australia.
  
  
  METHODS
  Inclusion criteria were community dwelling, aged 60 and older, presenting to an ED after a fall, and discharged directly home. Exclusion criteria were unable to follow simple instructions or walk independently.
  
  
  METHODS
  Targeted referrals to existing community services and health promotion recommendations, based on the falls risk factors found in a baseline assessment.
  
  
  METHODS
  Primary outcome measures were falls and resultant injuries occurring over the 12-month follow-up period. Falls and injury data were collected using falls calendars supported by medical record reviews.
  
  
  RESULTS
  Three hundred sixty-one participants were randomized to the standard care group and 351 to the intervention group. No significant difference was found between the two groups over the 12-month follow-up period in number of fallers (relative risk (RR)=1.11, 95% confidence interval (CI)=0.95-1.31] or number of participants sustaining an injury from a fall (RR=1.06, 95% CI=0.86-1.29).
  
  
  CONCLUSIONS
  This study does not support the use of a referral-based targeted multifactorial intervention program to reduce subsequent falls or fall injuries in older people who present to an ED after a fall.
authors.affiliation: Preventive and Public Health Division, National Ageing Research Institute, Parkville, Victoria, Australia. melissar@unimelb.edu.au
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Russell
authors.forename: Keith D
authors.initials: KD
authors.lastname: Hill
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Day
authors.forename: Irene
authors.initials: I
authors.lastname: Blackberry
authors.forename: Jenny
authors.initials: J
authors.lastname: Schwartz
authors.forename: Melita J
authors.initials: MJ
authors.lastname: Giummarra
authors.forename: Michael
authors.initials: M
authors.lastname: Dorevitch
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Ibrahim
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Dalton
authors.forename: Shyamali C
authors.initials: SC
authors.lastname: Dharmage
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003153:Community Health Services; D004636:Emergency Service, Hospital; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000517:prevention & control*