Approach to Prevent Fall Injuries No Better Than Usual Care

A new study published in the New England Journal of Medicine tested a fall injury intervention tailored to individuals and administered by specially trained nurses, reports the U.S. National Institute on Aging . More than 5,400 participants 70 and older were enrolled at 86 primary care practices across 10 U.S. healthcare systems. The older participants had been injured from a fall, had fallen at least twice in the previous year, or were afraid of falling due to difficulty walking or balancing. Volunteers were initially screened for fall injury risk factors, including problems with walking and balance, falling risks in the home, vision difficulties, problems with feet or shoes, weakened bones, certain drugs, and low blood pressure when standing. Specially trained nurses helped half of the participants to identify risk factors and work to reduce one to three of them, while the rest were controls. Controls got an informational pamphlet on falls and were encouraged to discuss fall prevention with primary care doctors, who also received the risk factor screening results. The overall rate of serious fall injuries was much lower about 5 percent than expected, while the gap in the rate of serious fall injuries between the two groups was small. "Measures that may reduce risk in the setting of a clinical trial can be less effective in the real world, where daily challenges such as being unable to afford transportation, or the cost of follow-up care, may delay or prevent access for patients," noted Shalender Bhasin of Brigham and Women's Hospital.