Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults.
Older adults frequently fall after discharge from hospital. Older people may have low self-perceived risk of falls and poor knowledge about falls prevention. The primary aim of the study is to evaluate the effect of providing tailored falls prevention education in addition to usual care on falls rates in older people after discharge from hospital compared to providing a social intervention in addition to usual care.



The 'Back to My Best' study is a multisite, single blind, parallel-group randomised controlled trial with blinded outcome assessment and intention-to-treat analysis, adhering to CONSORT guidelines. Patients (n=390) (aged 60 years or older; score more than 7/10 on the Abbreviated Mental Test Score; discharged to community settings) from aged care rehabilitation wards in three hospitals will be recruited and randomly assigned to one of two groups. Participants allocated to the control group shall receive usual care plus a social visit. Participants allocated to the experimental group shall receive usual care and a falls prevention programme incorporating a video, workbook and individualised follow-up from an expert health professional to foster capability and motivation to engage in falls prevention strategies. The primary outcome is falls rates in the first 6 months after discharge, analysed using negative binomial regression with adjustment for participant's length of observation in the study. Secondary outcomes are injurious falls rates, the proportion of people who become fallers, functional status and health-related quality of life. Healthcare resource use will be captured from four sources for 6 months after discharge. The study is powered to detect a 30% relative reduction in the rate of falls (negative binomial incidence ratio 0.70) for a control rate of 0.80 falls per person over 6 months.



Results will be presented in peer-reviewed journals and at conferences worldwide. This study is approved by hospital and university Human Research Ethics Committees.



ACTRN12615000784516.
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Anne-Marie
AM
Hill
Royal Perth Hospital Unit, WA Centre for Health and Ageing, School of Medicine & Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia.
Christopher
C
Etherton-Beer
Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia.|Institute of Health and Biomedical Innovation and School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Steven M
SM
McPhail
La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University & Healthscope, Melbourne, Victoria, Australia.
Meg E
ME
Morris
Royal Perth Hospital Unit, WA Centre for Health and Ageing, School of Medicine & Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia.
Leon
L
Flicker
Malcom Randall VA Medical Center, Gainesville, Florida, USA.
Ronald
0000-0002-1457-4668
R
Shorr
Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
Max
M
Bulsara
ACH Group, Health and Community Services, Burwood, Victoria, Australia.|Physiotherapy Department, Monash University, Melbourne, Victoria, Australia.
Den-Ching
DC
Lee
Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.|School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
Jacqueline
J
Francis-Coad
Armadale Kelmscott Memorial Hospital, Perth, Western Australia, Australia.
Nicholas
N
Waldron
St John of God Midland Public Hospital, Midland, Western Australia, Australia.
Amanda
A
Boudville
Physiotherapy Department, Monash University, Melbourne, Victoria, Australia.|Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia.
Terry
T
Haines
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D057194:Intention to Treat Analysis; D008875:Middle Aged; D009042:Motivation; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods*; D012107:Research Design; D020377:Self Efficacy; D016037:Single-Blind Method
GERIATRIC MEDICINE; PREVENTIVE MEDICINE