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Age and Ageing 2009 38(2):194-199; doi:10.1093/ageing/afn297
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT)

Jacques C. L. Neyens1,2, Béatrice P. J. Dijcks2, Jos Twisk3, Jos M. G. A. Schols1, Jolanda C. M. van Haastregt1, Wim J. A. van den Heuvel1 and Luc P. de Witte1,2

1 Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200MD, The Netherlands
2 iRv—Rehabilitation Research, Hoensbroek 6430AD, The Netherlands
3 Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam 1007MB, The Netherlands

Address correspondence to: J. C. L. Neyens. Tel: (+31) (0) 43 388 12 79; Fax: (+31) (0) 162 51 90 21; Email: j.neyens{at}zw.unimaas.nl

Objective: to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients.

Design: cluster-randomised controlled 12-month trial.

Setting: psychogeriatric wards in 12 nursing homes in The Netherlands.

Participants: psychogeriatric nursing home patients (n = 518).

Intervention: a general medical assessment and an additional specific fall risk evaluation tool, applied by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities.

Measurements: falls.

Results: there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward-related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43–0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme.

Conclusion: the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduces the number of falls. This reduction is substantial and of high clinical relevance.

Keywords: accidental falls, prevention, older people, long-term care, dementia, elderly

Received 11 November 2007; accepted in revised form 29 August 2008.


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