title: Telephone Care Management of Fall Risk:: A Feasibility Study.
abstract: BACKGROUND
  Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall.
  
  
  METHODS
  The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed.
  
  
  RESULTS
  Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up.
  
  
  CONCLUSIONS
  Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention.
authors.affiliation: Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington; Health Promotion Research Center, Department of Health Services, School of Public Health, University of Washington, Seattle, Washington. Electronic address: phelane@u.washington.edu.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Phelan
authors.affiliation: Northwest Physicians Network of Washington, Tacoma, Washington.
authors.forename: Maureen
authors.initials: M
authors.lastname: Pence
authors.affiliation: Health Promotion Research Center, Department of Health Services, School of Public Health, University of Washington, Seattle, Washington.
authors.forename: Barbara
authors.initials: B
authors.lastname: Williams
authors.affiliation: Northwest Physicians Network of Washington, Tacoma, Washington.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: MacCornack
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D013689:Telephone