title: Primary care physicians perceptions and practices regarding fall prevention in adult's 65 years and over.
abstract: BACKGROUND
  Falls are the leading cause of injury deaths and the most common cause of disability, premature nursing home admissions, medical costs, and hospitalizations among people 65 years and over. Interventions targeting multiple fall risk factors can reduce fall rates by 30-40%. Yet, national studies show that screening conducted by physicians for older adult falls is short of acceptable standards. Tri-County Health Department (TCHD) in Colorado conducted a study to examine fall prevention practices among primary care physicians in our jurisdiction.
  
  
  METHODS
  TCHD randomly sampled primary care physicians (n=100) obtained from a statewide healthcare provider database and surveyed them about fall prevention screening practices and perceived barriers to screening. Data were examined using single and multiple logistic regression analysis.
  
  
  RESULTS
  The response rate was 67.6%. Only 8% of responding physicians based their fall prevention practices on clinical guidelines from any recognized organizations. Frequently reported barriers included a lack of time during visits, more pressing issues, and a lack of educational materials. Physicians who did not accept Medicare (OR 0.163 [CI 0.03-0.84]) remained significantly less likely to refer patients for home safety assessments than those who did, on multivariate analysis.
  
  
  CONCLUSIONS
  This study reveals certain physicians require targeted interventions to improve fall prevention practices and use of clinical guidelines. Recommendations include providing physicians with trainings, screening guides, educational materials, environmental/home safety checklists, and referral resources.
authors.affiliation: Tri-County Health Department, Greenwood Village, CO, United States. tjones@tchd.org
authors.forename: Taylor S
authors.initials: TS
authors.lastname: Jones
authors.forename: Tista S
authors.initials: TS
authors.lastname: Ghosh
authors.forename: Kimberley
authors.initials: K
authors.lastname: Horn
authors.forename: Jana
authors.initials: J
authors.lastname: Smith
authors.forename: Richard L
authors.initials: RL
authors.lastname: Vogt
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003120:Colorado; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D010353:Patient Education as Topic; D058007:Physicians, Primary Care / Q000523:psychology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*