Skip Navigation


Age and Ageing Advance Access first published online on October 1, 2008
This version published online on October 1, 2008
Age and Ageing, doi:10.1093/ageing/afn192
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Supplementary Data
Right arrow All Versions of this Article:
38/1/33    most recent
afn192v2
afn192v1
Right arrow E-letters: Submit a response
Right arrow E-letters: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Spice, C. L.
Right arrow Articles by Gordon, C. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Spice, C. L.
Right arrow Articles by Gordon, C. J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The Winchester falls project: a randomised controlled trial of secondary prevention of falls in older people*

Claire L. Spice1, Wendy Morotti2, Steve George3, Thomas H. S. Dent4, Jim Rose5, Scott Harris6 and Christopher J. Gordon7

1 Consultant, Department of Medicine for Older People, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Southwick Hill, Cosham, PO6 3LY, UK
2 Project Research Nurse, Mid Hampshire Primary Care Trust, Tidbury Farm, Bullington Cross, Sutton Scotney, Hampshire, SO21 3QQ
3 Director of University of Southampton Clinical Trials Unit MP131, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
4 Mid Hampshire Primary Care Trust, Tidbury Farm, Bullington Cross, Sutton Scotney, Hampshire, SO21 3QQ
5 GP Principal. Derrydown Clinic, St Mary Bourne, Andover, UK
6 Statistician, Public Health Sciences and Medical Statistics Group, University of Southampton School of Medicine, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
7 Consultant Physician, Medicine and Elderly Care, Royal Hampshire County Hospital, Romsey Road, Winchester SO22 5DG, UK

Address correspondence to: Claire Spice, Department Medicine for Older People, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Southwick Hill, Cosham, PO6 3LY, UK. Email: claire.spice{at}porthosp.nhs.uk

Background: the mortality and morbidity of falls in older people is significant, with recurrent fallers being at an increased risk. The most effective way to reduce falls in this group is not clear.

Objective: to determine the effectiveness of two interventions, one based in primary care and the other in secondary care, at preventing further falls in recurrent fallers.

Design: cluster randomised controlled trial.

Participants: sixty-five years or over, living in the community, two or more falls in the previous year and not presenting to an emergency department with index fall.

Setting: Mid Hampshire, UK.

Intervention: eighteen general practices were randomly allocated to one of three groups. The primary care group was assessed by nurses in the community, using a risk factor review and subsequent targeted referral to other professionals. The secondary care group received a multi-disciplinary assessment in a day hospital followed by identified appropriate interventions. The control group received usual care. Follow-up was for 1 year.

Results: five hundred and five participants were recruited. Follow-up was completed in 83% (421/505). The proportion of participants who fell again was significantly lower in the secondary care group (75%, 158/210) compared to the control group [84%, 133/159, adjusted odds ratio (OR) 0.52 (95% CI 0.35–0.79) P = 0.002]. The primary care group showed similar results to the control group [87%, 118/136, adjusted OR 1.17 (95% CI 0.57–2.37) P = 0.673].

Conclusion: a structured multi-disciplinary assessment of recurrent fallers significantly reduced the number experiencing further falls, but a community-based nurse-led assessment with targeted referral to other professionals did not.

Keywords: elderly, older people, prevention, randomised controlled trial, recurrent falls

* This study was a joint initiative between the Royal Hampshire County Hospital and Mid-Hampshire Primary Care Trust with the work being carried out within the community and at the Royal Hampshire County Hospital.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Age AgeingHome page
P.M. Ciaschini, S.E. Straus, L.R. Dolovich, R.A. Goeree, K.M. Leung, C.R. Woods, G.M. Zimmerman, S.R. Majumdar, S. Spadafora, L.A. Fera, et al.
Community-based intervention to optimise falls risk management: a randomised controlled trial
Age Ageing, November 1, 2009; 38(6): 724 - 730.
[Abstract] [Full Text] [PDF]

Home page
 IBMS BoneKEyHome page
J. C.T. Close
Falls in Older People: Risk Factors, Assessment and Intervention
IBMS BoneKEy, October 1, 2009; 6(10): 368 - 384.
[Abstract] [Full Text] [PDF]

E-letters:

Read all E-letters

Medication review and falls
David P Alldred
Age and Ageing, 19 Feb 2009 [Full text]

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.