Tailored education for older patients to facilitate engagement in falls prevention strategies after hospital discharge--a pilot randomized controlled trial

PLoS One. 2013 May 23;8(5):e63450. doi: 10.1371/journal.pone.0063450. Print 2013.

Abstract

Background: The aims of the study were to evaluate the effect of providing tailored falls prevention education in hospital on: i) engagement in targeted falls prevention behaviors in the month after discharge: ii) patients' self-perceived risk and knowledge about falls and falls prevention strategies after receiving the education.

Methods: A pilot randomized controlled trial (n = 50): baseline and outcome assessments conducted by blinded researchers.

Participants: hospital inpatients 60 years or older, discharged to the community. Participants were randomized into two groups. The intervention was a tailored education package consisting of multimedia falls prevention information with trained health professional follow-up, delivered in addition to usual care. Outcome measures were engagement in falls prevention behaviors in the month after discharge measured at one month after discharge with a structured survey, and participants' knowledge, confidence and motivation levels before and after receiving the education. The feasibility of providing the intervention was examined and falls outcomes (falls, fall-related injuries) were also collected.

Results: Forty-eight patients (98%) provided follow-up data. The complete package was provided to 21 (84%) intervention group participants. Participants in the intervention group were significantly more likely to plan how to safely restart functional activities [Adjusted odds ratio 3.80, 95% CI (1.07, 13.52), p = 0.04] and more likely to complete other targeted behaviors such as completing their own home exercise program [Adjusted odds ratio 2.76, 95% CI (0.72, 10.50), p = 0.14] than the control group. The intervention group was significantly more knowledgeable, confident and motivated to engage in falls prevention strategies after receiving the education than the control group. There were 23 falls (n = 5 intervention; n = 18 control) and falls rates were 5.4/1000 patient days (intervention); 18.7/1000 patient days (control).

Conclusion: This tailored education was received positively by older people, resulted in increased engagement in falls prevention strategies after discharge and is feasible to deliver to older hospital patients.

Trial registration: The study was registered with the Australian New Zealand Clinical Trials Registry; ACTRN12611000963921 on 8th November 2011.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidents, Home / prevention & control*
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Multimedia
  • Patient Discharge
  • Patient Education as Topic / methods*
  • Pilot Projects
  • Precision Medicine
  • Treatment Outcome

Grants and funding

This study was funded by a grant awarded to Anne-Marie Hill by The Sir Robert Menzies Memorial Foundation Limited which is a non-profit, non-political organisation created in 1979 to promote excellence in health research, scholarship and postgraduate study by Australians. The Foundation had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. http://www.menziesfoundation.org.au/ Anne-Marie Hill is supported by an Australian National Health and Medical Research Council Early Career Fellowship. Terry Haines is supported by an Australian National Health and Medical Research Council Career Development Fellowship.