A core outcome set for evaluating the effectiveness of mixed-diagnosis falls prevention interventions for people with Multiple Sclerosis, Parkinson's Disease and stroke

PLoS One. 2023 Nov 13;18(11):e0294193. doi: 10.1371/journal.pone.0294193. eCollection 2023.

Abstract

Introduction: Clinical trials evaluating the effectiveness of falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson's Disease (PD) and stroke measure heterogeneous outcomes, often omitting those meaningful to patients. A core outcome set (COS) is a standardised set of outcomes that should be assessed in all trials within a research area. The aim of this study was to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke in non-acute and community settings, with input from relevant stakeholder groups.

Methods: Previously published research undertaken by the team, including a qualitative study with 20 patients and a review of the literature, were used to derive a longlist of potential outcomes. Outcomes were prioritised for inclusion in the COS using a three-round online Delphi survey. A multi-stakeholder, consensus meeting was conducted to agree upon the final COS and to provide a recommendation for a single outcome measure for each outcome in the COS.

Results: Forty-eight participants were recruited across four stakeholder groups (researchers, patients, clinicians, and service-planners/policymakers). A total of 42 participants (87.5%) completed all three rounds of the surveys. Sixty-two outcomes were considered for inclusion in the COS throughout the Delphi process. A total of 15 participants attended the consensus meeting where they agreed upon the final COS and accompanying measurement instruments: fall incidence, injurious fall incidence, quality of life, falls self-efficacy, fear of falling, activity curtailment due to fear of falling, and cost-effectiveness. Attendees at the consensus meeting recommended that the proposed mechanism of impact of an intervention is considered when selecting additional outcomes outside of those in the COS to assess.

Conclusions: This study identified a COS for evaluating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke. It is recommended that this COS and accompanying measurement instruments be used in all future trials in this research area so that findings can be combined and compared.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delphi Technique
  • Fear
  • Humans
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / diagnosis
  • Outcome Assessment, Health Care
  • Parkinson Disease* / diagnosis
  • Quality of Life
  • Research Design
  • Stroke* / diagnosis
  • Stroke* / prevention & control
  • Treatment Outcome

Grants and funding

NO'M is a postgraduate scholar funded by the Irish Research Council through the Government of Ireland Postgraduate Scholarship Programme under award number GOIPG/2018/3379. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.