title: Differing approaches to falls and fracture prevention between Australia and Colombia.
abstract: Falls and fractures are major causes of morbidity and mortality in older people. More importantly, previous falls and/or fractures are the most important predictors of further events. Therefore, secondary prevention programs for falls and fractures are highly needed. However, the question is whether a secondary prevention model should focus on falls prevention alone or should be implemented in combination with fracture prevention. By comparing a falls prevention clinic in Manizales (Colombia) versus a falls and fracture prevention clinic in Sydney (Australia), the objective was to identify similarities and differences between these two programs and to propose an integrated model of care for secondary prevention of fall and fractures. A comparative study of services was performed using an internationally agreed taxonomy. Service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE) and previous reports in the literature. Comparison included organization, administration, client characteristics, and interventions. Several similarities and a number of differences that could be easily unified into a single model are reported here. Similarities included population, a multidisciplinary team, and a multifactorial assessment and intervention. Differences were eligibility criteria, a bone health assessment component, and the therapeutic interventions most commonly used at each site. In Australia, bone health assessment is reinforced whereas in Colombia dizziness assessment and management is pivotal. The authors propose that falls clinic services should be operationally linked to osteoporosis services such as a "falls and fracture prevention clinic," which would facilitate a comprehensive intervention to prevent falls and fractures in older persons.
authors: Research Group on Geriatrics and Gerontology, International Association of Gerontology and Geriatrics Collaborative Center, University of Caldas, Manizales, Colombia.
authors: Fernando
authors: F
authors: Gomez
authors: Carmen Lucia
authors: CL
authors: Curcio
authors: Pushpa
authors: P
authors: Suriyaarachchi
authors: Oddom
authors: O
authors: Demontiero
authors: Gustavo
authors: G
authors: Duque
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D015519:Bone Density; D003105:Colombia; D004244:Dizziness / Q000517:prevention & control / Q000628:therapy; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control*; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration; D017678:Sex Distribution
keywords: falls and fracture services; geriatric health services; outpatient clinics; secondary prevention
references: J Am Geriatr Soc. 2007 Oct;55 Suppl 2:S327-34
references: 17910554
references: J Nutr Health Aging. 2012 Mar;16(3):270-5
references: 22456785
references: Arch Phys Med Rehabil. 1988 Sep;69(9):689-91
references: 3421823
references: Age Ageing. 2003 Sep;32(5):494-6
references: 12957997
references: Nurs Older People. 2007 Dec;19(10):34-8; quiz 39
references: 18220068
references: Aust Health Rev. 2004 Dec 13;28(3):374-81
references: 15595921
references: Aust Health Rev. 2001;24(4):163-74
references: 11842706
references: Ann Intern Med. 2010 Dec 21;153(12):815-25
references: 21173416
references: Am J Phys Med Rehabil. 2006 Nov;85(11):882-8
references: 17079960
references: Arch Phys Med Rehabil. 2008 Jul;89(7):1329-34
references: 18586135
references: J Nutr Health Aging. 2011 Feb;15(2):140-5
references: 21365168
references: Aging Clin Exp Res. 2010 Apr;22(2):170-4
references: 20440103
references: Scand J Caring Sci. 2009 Sep;23(3):473-81
references: 19077063
references: J Nutr Health Aging. 2011 Jun;15(6):490-7
references: 21623472
references: Clin Geriatr Med. 2010 Nov;26(4):733-49
references: 20934619
references: BMJ. 2000 Oct 21;321(7267):1007-11
references: 11039974
references: J Am Geriatr Soc. 2005 Sep;53(9):1618-22
references: 16137297
references: J Am Geriatr Soc. 2010 Feb;58(2):357-63
references: 20370859
references: Am J Phys Med Rehabil. 2001 Dec;80(12):909-15
references: 11821673
references: J Am Geriatr Soc. 2008 Apr;56(4):600-8
references: 18266663