title: Falls prevention in persons with intellectual disabilities: development, implementation, and process evaluation of a tailored multifactorial fall risk assessment and intervention strategy.
abstract: In the general elderly population, multifactorial screening of fall risks has been shown to be effective. Although persons with intellectual disabilities (ID) fall more often, there appears to be no targeted screening for them. The aim of this study was to develop, implement, and evaluate a falls clinic for persons with ID. Based on guidelines, literature, and expert meetings, a falls clinic for persons with ID was developed. In total, 26 persons with ID and a fall history participated in the study. Process evaluation was conducted with evaluation forms and focus groups. Fifty interventions (0-8 per person) were prescribed. The (para)medical experts, clients, and caregivers described the falls clinic as useful. Advice for improvement included minor changes to clinic content. Logistics were the largest challenge for the falls clinic, for example organizing meetings, completing questionnaires prior to meetings, and ensuring that a personal caregiver accompanied the person with ID. Furthermore, the need for a screening tool to determine whether a person would benefit from the falls clinic was reported. In conclusion, the falls clinic for persons with ID was considered feasible and useful. Some minor content changes are necessary and there is a need for a screening tool. However, logistics concerning the falls clinic need improvement. More attention and time for multifactorial and multidisciplinary treatment of persons with ID is necessary. Implementation on a larger scale would also make it possible to investigate the effectiveness of the falls clinic with regard to the prevention of falls in this population.
authors.affiliation: Radboud University Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, Nijmegen, The Netherlands. ellen.smulders@tolbrug.nl
authors.forename: Ellen
authors.initials: E
authors.lastname: Smulders
authors.forename: Lotte
authors.initials: L
authors.lastname: Enkelaar
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Schoon
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Geurts
authors.forename: Henny
authors.initials: H
authors.lastname: van Schrojenstein Lantman-de Valk
authors.forename: Vivian
authors.initials: V
authors.lastname: Weerdesteyn
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D003253:Consultants; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D016730:Program Development; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017751:Safety Management / Q000458:organization & administration*
keywords: Falls; Falls clinic; Falls prevention; Intellectual disabilities