title: Characteristics and effectiveness of fall prevention programs in nursing homes: a systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To determine characteristics and effectiveness of prevention programs on fall-related outcomes in a defined setting.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  A clearly described subgroup of nursing homes defined as residential facilities that provide 24-hour-a-day surveillance, personal care, and limited clinical care for persons who are typically elderly and infirm.
  
  
  METHODS
  Nursing home residents (N = 22,915).
  
  
  METHODS
  The primary outcomes were number of falls, fallers, and recurrent fallers.
  
  
  RESULTS
  Thirteen studies met the inclusion criteria. Six fall prevention programs were single (one intervention component provided to the residents), one was multiple (two or more intervention components not customized to individual fall risk), and six were multifactorial (two or more intervention components customized to each resident's fall risk). Meta-analysis found significantly fewer recurrent fallers in the intervention groups (4 studies, relative risk (RR) = 0.79, 95% confidence interval (CI) = 0.65-0.97) but no significant effect of the intervention on fallers (6 studies, RR = 0.97, 95% CI = 0.84-1.11) or falls (10 studies, RR = 0.93, 95% CI = 0.76-1.13). Multifactorial interventions significantly reduced falls (4 studies, RR = 0.67, 95% CI = 0.55-0.82) and the number of recurrent fallers (4 studies, RR = 0.79, CI = 0.65-0.97), whereas single or multiple interventions did not. Training and education showed a significant harmful effect in the intervention groups on the number of falls (2 studies, RR = 1.29, 95% CI = 1.23-1.36).
  
  
  CONCLUSIONS
  This meta-analysis failed to reveal a significant effect of fall prevention interventions on falls or fallers but, for the first time, showed that fall prevention interventions significantly reduced the number of recurrent fallers by 21%.
authors: Department of Public Health and Primary Care, Health Services and Nursing Research, KU Leuven, Leuven, Belgium.
authors: Ellen
authors: E
authors: Vlaeyen
authors: Joke
authors: J
authors: Coussement
authors: Greet
authors: G
authors: Leysens
authors: Elisa
authors: E
authors: Van der Elst
authors: Kim
authors: K
authors: Delbaere
authors: Dirk
authors: D
authors: Cambier
authors: Kris
authors: K
authors: Denhaerynck
authors: Stefan
authors: S
authors: Goemaere
authors: Arlette
authors: A
authors: Wertelaers
authors: Fabienne
authors: F
authors: Dobbels
authors: Eddy
authors: E
authors: Dejaeger
authors: Koen
authors: K
authors: Milisen
mesh_terms: D000056:Accident Prevention; D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D006801:Humans; D009735:Nursing Homes; D016032:Randomized Controlled Trials as Topic
keywords: accidental falls; meta-analysis; multifactorial interventions; prevention; residential aged care facilities