Telephone Care Management of Fall Risk:: A Feasibility Study (original) (raw)
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Frontiers in public health, 2015
Among older adults, falls are the leading cause of injury-related deaths and emergency department visits, and the incidence of falls in the United States is rising as the number of older Americans increases. Research has shown that falls can be reduced by modifying fall-risk factors using multifactorial interventions implemented in clinical settings. However, the literature indicates that many providers feel that they do not know how to conduct fall-risk assessments or do not have adequate knowledge about fall prevention. To help healthcare providers incorporate older adult fall prevention (i.e., falls risk assessment and treatment) into their clinical practice, the Centers for Disease Control and Prevention's (CDC) Injury Center has developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool kit. This study was conducted to identify the practice characteristics and providers' beliefs, knowledge, and fall-related activities before they received training on h...
Archives of Gerontology and Geriatrics, 2005
We wanted to determine whether women aged 70 years and older, who presented to the emergency department (ED) with a fall and injury, received guideline care within 18 months of presentation. Women aged 70 years and older who presented to the ED with a fall were recorded prospectively from August 1, 2001 to May 1, 2002 (n = 226). Structured telephone interviews were performed 18 months after the ED fall to obtain details of patient management (n = 63). The most frequently reported referral was to the family physician (32%) and to physiotherapy (24%). We concluded that most older women who presented to the ED with a fall did not appear to be receiving current guideline care. We propose that future research use a prospective study design to assess whether or not guideline care is being delivered by a variety of health care providers after the patients leave the ED. # 2005 Published by Elsevier Ireland Ltd.
Injury epidemiology, 2017
Falls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury. We enrolled English speaking patients, aged ≥ 65 years, who presented to the ED of an urban level one trauma center with a fall or fall related injury and discharged home. During subjects' initial visits to the ED, we screened and enrolled patients, gathered patient demographics and provided them with a flyer for a Matter of Balance course. Sixty-days post enrollment, we conducted a phone follow-up interview to collect information on post-fall behaviors including information regardi...
PLOS Medicine
Background Falls are a leading reason for older people presenting to the emergency department (ED), and many experience further falls. Little evidence exists to guide secondary prevention in this population. This randomised controlled trial (RCT) investigated whether a 6-month telephone-based patient-centred program-RESPOND-had an effect on falls and fall injuries in older people presenting to the ED after a fall. Methods and findings Community-dwelling people aged 60-90 years presenting to the ED with a fall and planned for discharge home within 72 hours were recruited from two EDs in Australia. Participants were enrolled if they could walk without hands-on assistance, use a telephone, and were free of cognitive impairment (Mini-Mental State Examination > 23). Recruitment occurred between 1 April 2014 and 29 June 2015. Participants were randomised to receive either RESPOND (intervention) or usual care (control). RESPOND comprised (1) home-based risk assessment; (2) 6 months telephone-based education, coaching, goal setting, and
Health Education Research, 2013
The objectives of this study were to describe the sources of falls prevention information provided to older adults during and after hospitalization, identify and explore reasons why discussion about falls prevention may not take place. Six participant groups were interviewed using semi-structured interviews or focus groups: (i) older patients (n ¼ 16); (ii) caregivers (n ¼ 8); (iii) allied health and nursing professionals (n ¼ 33); (iv) doctors from acute wards (n ¼ 8); (v) doctors from subacute wards (n ¼ 10) and (vi) general practitioners (n ¼ 9). Participants were recruited from three Australian hospitals that provided acute and subacute in-patient services to the older adults. General practitioners were recruited from the community of Melbourne. Findings showed provision of falls prevention information was dependent on setting of the ward and which health professionals the older adult encountered during and after hospitalization. Medical practitioners were reactive in providing information, whereas older adults and their caregivers were passive in seeking falls prevention information. Several barriers in information provision and information seeking were identified. There is great potential to improve the consistency of falls prevention information provision to older adults during hospitalization and in preparation for discharge to assist with prevention of falls in this high risk period.
Australian Occupational Therapy Journal, 2019
Introduction: Falls are an important issue in primary care. General practitioners (GPs) are in a key position to identify older people at risk of falls on their caseload and put preventative plans into action. Chronic Disease Management (CDM) plans allow GPs to refer to allied health practitioners (AHPs) for evidence-based falls interventions. A previous pilot study reduced falls risk factors using CDM pans with older people at risk of falls. This study aimed to conduct a process evaluation of how the intervention worked in the pilot study for providers and consumers. Methods: This process evaluation used qualitative descriptive methods by interviewing the GPs, AHPs and older people involved in the intervention study. An independent researcher conducted interviews. These were audiotaped, transcribed and analysed using thematic analysis. Data were also collected about the implementation of the programme. Results: Two GPs, three occupational therapists, three physiotherapists and eight older people were interviewed. Key themes emerged from the perspectives of providers and consumers. The programme was implemented as intended, adherence to the exercise diaries was variable and the falls calendars were fully completed for three months of follow-up. The programme was implemented as intended. Conclusion: The pilot CDM falls prevention programme did not identify common barriers attributed to GPs. Older people were amenable to the programme and participated freely. Private AHPs needed to make the CDM items work for their business model. This approach can be rolled out in a larger study and integrated pathways are needed to identify and intervene with older people at risk of falls in primary care. K E Y W O R D S accidental falls, ageing, chronic disease, community health services, occupational therapy How to cite this article: Mackenzie L, Clemson L, Irving D. Fall prevention in primary care using chronic disease management plans: A process evaluation of provider and consumer perspectives.