Fall Injury Prevention Intervention Shows Improvements Among OAs

Researchers designed the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) trial to reduce falls among older adults (OAs), which can often result in serious injuries.

The cluster-randomized trial included 86 primary care practices across 10 health systems in which a multifactorial intervention to prevent fall injuries was led by registered nurses who were trained as falls care managers or enhanced usual care. There were 5451 community-dwelling OAs aged 70 years or older at increased fall injury risk included in STRIDE.

“Across a standard set of outcomes typically reported in fall prevention studies, we observed modest improvements, one of which was statistically significant,” wrote researchers.

Researchers examined fall-related outcomes every 4 months through interviews of participants or proxies. Health related quality of life (HRQOL) was assessed at baseline, 12-, and 24-month intervals utilizing the EQ-5D-5L and EQ-VAS.

To examine intervention effects on falls, fall-related fractures, fall injuries leading to hospital admission, and fall injuries leading to medical attention study authors used Poisson models and hierarchical longitudinal linear models were used to assess HRQOL.

“For recurrent event models, intervention vs control incidence rate ratios were 0.97 (95% confidence interval [CI], 0.93-1.00; P = .048) for falls, 0.93 (95% CI, 0.80-1.08; P = .337) for self-reported fractures, 0.89 (95% CI, 0.73–1.07; P = .205) for adjudicated fractures, 0.91 (95% CI, 0.77-1.07; P = .263) for falls leading to hospital admission, and 0.97 (95% CI, 0.89-1.06; P = .477) for falls leading to medical attention,” wrote researchers.

Researchers obtained non-significant similar effect sizes for dichotomous outcomes including participants with ≥1 event.

Results showed 0.009 (95% CI, −0.002 to 0.019; P = .106) at 12 months and 0.005 (95% CI, −0.006 to 0.015; P = .384) at 24 months was the difference in least square mean change over time in EQ-5D-5L (intervention minus control).

“Future work should focus on patient-, practice-, and organization-level operational strategies to increase the real-world effectiveness of interventions, and improving the ability to detect small but potentially meaningful clinical effects,” concluded study authors.

Reference:
Ganz DA, Yuan AH, Greene EJ, et al. Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health-related quality of life. J Am Geriatr Soc. Published online August 6, 2022. doi:10.1111/jgs.17964