NEJM study highlights difficulties in implementing fall prevention programs

A fall intervention program administered by nurses did not significantly lower the rate of serious fall injury compared to usual care, highlighting the difficulties in implanting these types of interventions in real world settings, according to a study published in New England Journal of Medicine.

Researchers conducted a pragmatic, cluster-randomized trial to evaluate a multifactorial intervention program administered by specially trained nurses to prevent fall injuries amongst participants 70 years of age or older and at increased risk for fall injuries.

Patients underwent a risk assessment for strength impairment, gait, balance, medication use, postural hypotension and issues with feet or footwear, osteoporosis/vitamin D deficiency, impaired vision, and home safety hazards, before an individualized care plan was created based on 1-3 risk factors.

Despite hypothesizing that the event rate would be 20% lower in the intervention group than in the control group, the rate of first serious fall injury did not differ significantly between the groups. The rates of hospitalization or death were similar between the intervention and control groups.

Reference

Bhasin S, Gill TM, Reuben DB, et al. A randomized trial of a multifactorial strategy to prevent serious fall injuries. N Engl J Med. 2020; 383:129-140
DOI: 10.1056/NEJMoa2002183.