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Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis

BACKGROUND: Limited attention has been paid in the literature to multiple component fall prevention interventions that comprise two or more fixed combinations of fall prevention interventions that are not individually tailored following a risk assessment. The study objective was to determine the eff...

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Autores principales: Goodwin, Victoria A, Abbott, Rebecca A, Whear, Rebecca, Bethel, Alison, Ukoumunne, Obioha C, Thompson-Coon, Jo, Stein, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928080/
https://www.ncbi.nlm.nih.gov/pubmed/24495705
http://dx.doi.org/10.1186/1471-2318-14-15
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author Goodwin, Victoria A
Abbott, Rebecca A
Whear, Rebecca
Bethel, Alison
Ukoumunne, Obioha C
Thompson-Coon, Jo
Stein, Ken
author_facet Goodwin, Victoria A
Abbott, Rebecca A
Whear, Rebecca
Bethel, Alison
Ukoumunne, Obioha C
Thompson-Coon, Jo
Stein, Ken
author_sort Goodwin, Victoria A
collection PubMed
description BACKGROUND: Limited attention has been paid in the literature to multiple component fall prevention interventions that comprise two or more fixed combinations of fall prevention interventions that are not individually tailored following a risk assessment. The study objective was to determine the effect of multiple component interventions on fall rates, number of fallers and fall-related injuries among older people and to establish effect sizes of particular intervention combinations. METHODS: Medline, EMBASE, CINAHL, PsychInfo, Cochrane, AMED, UK Clinical Research Network Study Portfolio, Current Controlled Trials register and Australian and New Zealand Clinical Trials register were systematically searched to August 2013 for randomised controlled trials targeting those aged 60 years and older with any medical condition or in any setting that compared multiple component interventions with no intervention, placebo or usual clinical care on the outcomes reported falls, number that fall or fall-related injuries. Included studies were appraised using the Cochrane risk of bias tool. Estimates of fall rate ratio and risk ratio were pooled across studies using random effects meta-analysis. Data synthesis took place in 2013. RESULTS: Eighteen papers reporting 17 trials were included (5034 participants). There was a reduction in the number of people that fell (pooled risk ratio = 0.85, 95% confidence interval (95% CI) 0.80 to 0.91) and the fall rate (pooled rate ratio = 0.80, 95% CI 0.72 to 0.89) in favour of multiple component interventions when compared with controls. There was a small amount of statistical heterogeneity (I(2) = 20%) across studies for fall rate and no heterogeneity across studies examining number of people that fell. CONCLUSIONS: This systematic review and meta-analysis of randomised controlled trials found evidence that multiple component interventions that are not tailored to individually assessed risk factors are effective at reducing both the number of people that fall and the fall rate. This approach should be considered as a service delivery option.
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spelling pubmed-39280802014-02-19 Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis Goodwin, Victoria A Abbott, Rebecca A Whear, Rebecca Bethel, Alison Ukoumunne, Obioha C Thompson-Coon, Jo Stein, Ken BMC Geriatr Research Article BACKGROUND: Limited attention has been paid in the literature to multiple component fall prevention interventions that comprise two or more fixed combinations of fall prevention interventions that are not individually tailored following a risk assessment. The study objective was to determine the effect of multiple component interventions on fall rates, number of fallers and fall-related injuries among older people and to establish effect sizes of particular intervention combinations. METHODS: Medline, EMBASE, CINAHL, PsychInfo, Cochrane, AMED, UK Clinical Research Network Study Portfolio, Current Controlled Trials register and Australian and New Zealand Clinical Trials register were systematically searched to August 2013 for randomised controlled trials targeting those aged 60 years and older with any medical condition or in any setting that compared multiple component interventions with no intervention, placebo or usual clinical care on the outcomes reported falls, number that fall or fall-related injuries. Included studies were appraised using the Cochrane risk of bias tool. Estimates of fall rate ratio and risk ratio were pooled across studies using random effects meta-analysis. Data synthesis took place in 2013. RESULTS: Eighteen papers reporting 17 trials were included (5034 participants). There was a reduction in the number of people that fell (pooled risk ratio = 0.85, 95% confidence interval (95% CI) 0.80 to 0.91) and the fall rate (pooled rate ratio = 0.80, 95% CI 0.72 to 0.89) in favour of multiple component interventions when compared with controls. There was a small amount of statistical heterogeneity (I(2) = 20%) across studies for fall rate and no heterogeneity across studies examining number of people that fell. CONCLUSIONS: This systematic review and meta-analysis of randomised controlled trials found evidence that multiple component interventions that are not tailored to individually assessed risk factors are effective at reducing both the number of people that fall and the fall rate. This approach should be considered as a service delivery option. BioMed Central 2014-02-05 /pmc/articles/PMC3928080/ /pubmed/24495705 http://dx.doi.org/10.1186/1471-2318-14-15 Text en Copyright © 2014 Goodwin et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Goodwin, Victoria A
Abbott, Rebecca A
Whear, Rebecca
Bethel, Alison
Ukoumunne, Obioha C
Thompson-Coon, Jo
Stein, Ken
Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis
title Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis
title_full Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis
title_fullStr Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis
title_full_unstemmed Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis
title_short Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis
title_sort multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928080/
https://www.ncbi.nlm.nih.gov/pubmed/24495705
http://dx.doi.org/10.1186/1471-2318-14-15
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