Authors' objectives:

The aim of this study was to systematically review the evidence for the effectiveness of fall prevention programs in long term care facilities (LTC).

Authors' results and conclusions: Benefits, Harms and Costs: Factors that lead to admission to LTC parallel the broad range of risk factors that predispose older adults to falling. To be effective in preventing falls, assessments require a multi-disciplinary approach that includes a review of patients medical history, cognition, strength and balance, nutrition, medications, and environmental hazards. Trials of programs tailored to the individual residents needs across a broad range of factors reduced the incidence of falls and injuries. Post-fall assessments often detected acute changes in a patients health. Prevention programs targeted only to residents considered to be at the highest risk, based on a previous history of falling, showed only modest or inconclusive effectiveness in reducing falls and injuries. Physiotherapy or exercise programs alone were not proven effective in reducing falls. No specific adverse effects of assessment or screening were reported in the studies however interventions that encourage increased activity and mobility without provision of adequate staff resources and safeguards may increase the risk of falling.

Authors' recommendations: The Canadian Task Force concludes that there is fair evidence to recommend multifactor assessment and intervention programs in LTC to prevent falls and reduce hip fractures. Specific intervention plans should be tailored to meet the individual's needs. Residents should be assessed on admission to a facility and re-assessed after a fall incident. The Task Force concludes that there is insufficient evidence to recommend prevention programs that are targeted exclusively to residents deemed at higher risk, even if intervention is multifaceted. The Task Force concludes that there is insufficient evidence to recommend selective interventions that address one domain of risk, such as exercise or physiotherapy alone, to reduce falls in LTC residents.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ctfphc.org/

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Task Force on Preventive Health Care

Contact Address: Canadian Task Force on Preventive Health Care, 100 Collip Circle, Suite 117, London, ON, N6G 4X8, Canada. Tel: 519-858-5181; Fax: 519-858-5112

Contact Name: ctf@ctfphc.org

Contact Email: ctf@ctfphc.org

Copyright: Canadian Task Force on Preventive Health Care (CTFPHC)