title: An Occupational Therapy Fall Reduction Home Visit Program for Community-Dwelling Older Adults in Hong Kong After an Emergency Department Visit for a Fall.
abstract: OBJECTIVE
  To investigate the effects of an occupational therapy fall reduction home visit program for older adults admitted to the emergency department (ED) for a fall and discharged directly home.
  
  
  METHODS
  Single-blind, multicenter, randomized, controlled trial.
  
  
  METHODS
  EDs in three acute care hospitals in Hong Kong.
  
  
  METHODS
  Individuals aged 65 and older who had fallen (N = 311).
  
  
  METHODS
  After screening for eligibility, 204 consenting individuals were randomly assigned to an intervention group (IG) and received a single home visit from an occupational therapist (OT) within 2 weeks after discharge from the hospital or a control group (CG) and received a well-wishing visit from a research assistant not trained in fall prevention.
  
  
  METHODS
  Both groups were followed for 12 months through telephone calls made every 2 weeks by blinded assessors with a focus on the frequency of falls. Another blinded assessor followed up on their status with telephone calls 4, 8, and 12 months after ED discharge. Prospective fall records on hospital admissions were retrieved from electronic databases; 198 individuals were followed for 1 year on an intention-to-treat basis.
  
  
  RESULTS
  The percentage of fallers over 1 year was 13.7% in the IG (n = 95) and 20.4% in the CG (n = 103). There were significant differences in the number of fallers (P = .03) and the number of falls (P = .02) between the two groups over 6 months. Significant differences were found in survival analysis for first fall at 6 months (log-rank test 5.052, P = .02) but not 9 or 12 months.
  
  
  CONCLUSIONS
  One OT visit after a fall was more effective than a well-wishing visit at reducing future falls at 6 months. A booster OT visit at 6 months is suggested.
authors.affiliation: Department of Occupational Therapy, Queen Mary Hospital, Hong Kong.
authors.forename: Mary Man-Lai
authors.initials: MM
authors.lastname: Chu
authors.affiliation: Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
authors.forename: Kenneth Nai-Kuen
authors.initials: KN
authors.lastname: Fong
authors.affiliation: Accident and Emergency Department, Princess Margaret Hospital, Hong Kong.
authors.forename: Albert Chau-Hung
authors.initials: AC
authors.lastname: Lit
authors.affiliation: Trauma and Emergency Centre, Prince of Wales Hospital, Hong Kong.
authors.forename: Timothy Hudson
authors.initials: TH
authors.lastname: Rainer
authors.affiliation: Department of Occupational Therapy, Princess Margaret Hospital, Hong Kong.
authors.forename: Stella Wai-Chee
authors.initials: SW
authors.lastname: Cheng
authors.affiliation: Department of Occupational Therapy, Prince of Wales Hospital, Hong Kong.
authors.forename: Frederick Lap-Yan
authors.initials: FL
authors.lastname: Au
authors.affiliation: Department of Occupational Therapy, Queen Mary Hospital, Hong Kong.
authors.forename: Henry Kwok-Kwong
authors.initials: HK
authors.lastname: Fung
authors.affiliation: Department of Community Medicine, University of Hong Kong, Hong Kong.
authors.forename: Chit-Ming
authors.initials: CM
authors.lastname: Wong
authors.affiliation: Accident and Emergency Department, Queen Mary Hospital, Hong Kong.
authors.forename: Hon-Kuan
authors.initials: HK
authors.lastname: Tong
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006792:House Calls; D006801:Humans; D008297:Male; D009788:Occupational Therapy; D055502:Secondary Prevention; D016037:Single-Blind Method
keywords: emergency department; falls reduction; home visit; occupational therapy; older adults