title: RESPOND--A patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall: protocol for a multicentre randomised controlled trial.
abstract: BACKGROUND
  Participation in falls prevention activities by older people following presentation to the emergency department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND programme, an intervention designed to improve older persons' participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies.
  
  
  METHODS
  A RCT at two tertiary referral EDs in Melbourne and Perth, Australia.
  
  
  METHODS
  528 community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who require an interpreter or hands-on assistance to walk; live in residential aged care or >50 km from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or a history of psychosis; are receiving palliative care or are unable to use a telephone will be excluded.
  
  
  METHODS
  Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates (1) a home-based risk factor assessment; (2) education, coaching, goal setting and follow-up telephone support for management of one or more of four risk factors with evidence of effective interventions and (3) healthcare provider communication and community linkage delivered over 6 months. Primary outcomes are falls and fall injuries per person-year.
  
  
  CONCLUSIONS
  RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease; however, evidence to support this approach in falls prevention is limited.
  
  
  BACKGROUND
  The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684).
authors: Health Services Research Unit, Centre of Research Excellence in Patient Safety, Division of Health Services and Global Health Research, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors: A L
authors: AL
authors: Barker
authors: Health Services Research Unit, Centre of Research Excellence in Patient Safety, Division of Health Services and Global Health Research, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors: P A
authors: PA
authors: Cameron
authors: School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia, Australia.
authors: K D
authors: KD
authors: Hill
authors: University of Western Australia, Perth, Western Australia, Australia Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia Harry Perkins Institute for Medical Research, Perth, Western Australia, Australia.
authors: L
authors: L
authors: Flicker
authors: Department of Physiotherapy, Monash University, and Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia.
authors: T P
authors: TP
authors: Haines
authors: Health Services Research Unit, Centre of Research Excellence in Patient Safety, Division of Health Services and Global Health Research, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors: J A
authors: JA
authors: Lowthian
authors: Health Networks Branch, System Policy and Planning, Department of Health, Government of Western Australia, Perth, Western Australia, Australia.
authors: N
authors: N
authors: Waldron
authors: University of Western Australia, Perth, Western Australia, Australia Harry Perkins Institute for Medical Research, Perth, Western Australia, Australia.
authors: G
authors: G
authors: Arendts
authors: The George Institute for Global Health, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia.
authors: J
authors: J
authors: Redfern
authors: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors: A
authors: A
authors: Forbes
authors: Health Services Research Unit, Centre of Research Excellence in Patient Safety, Division of Health Services and Global Health Research, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia.
authors: C A
authors: CA
authors: Brand
authors: University of Western Australia, Perth, Western Australia, Australia Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia Harry Perkins Institute for Medical Research, Perth, Western Australia, Australia.
authors: C D
authors: CD
authors: Etherton-Beer
authors: School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors: A M
authors: AM
authors: Hill
authors: Alfred Health, Melbourne, Victoria, Australia.
authors: P
authors: P
authors: Hunter
authors: Bournemouth University Dementia Institute and Psychology Department, Faculty of Science and Technology, Bournemouth University, Poole, Dorset, UK.
authors: S R
authors: SR
authors: Nyman
authors: Alfred Health, Melbourne, Victoria, Australia.
authors: D
authors: D
authors: Smit
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003153:Community Health Services / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004779:Environment Design; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011314:Preventive Health Services / Q000458:organization & administration*; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*