Non-pharmacological interventions to prevent falls in older patients

Clinical practice recommendations – the SENATOR ONTOP Series

J. M. Rimland, I. Abraha*, G. Dell'Aquila, A. Cruz-Jentoft, R. L. Soiza, A. Gudmundsson, M. Petrovic, D. O'Mahony, A. Cherubini

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives To develop explicit evidence-based recommendations for non-pharmacological interventions to prevent falls in older subjects using the GRADE approach to rate the quality of evidence and the strength of recommendations. Methods A multidisciplinary panel was constituted composed of geriatricians, a research nurse and a clinical epidemiologist. The GRADE approach was used to rate the evidence and to formulate recommendations. Results The critical outcomes were fall rate and number of fallers. Forty-five clinical questions and the associated recommendations were formulated for single, multiple and multifactorial non-pharmacological interventions in three different settings (home, care facilities and hospitals). Seven strong recommendations in favour, and one strong recommendation against, were formulated, all of which were supported by moderate-quality evidence. The remaining 37 clinical questions had weak recommendations. A strong recommendation was formulated in favour of exercise, as a single component, in groups and individually, for community-dwelling older people. Tai Chi was strongly recommended for older adults at risk of falling, living at home. Home safety assessment and modification was strongly recommended for older adults living at home and at high risk of falling. Multifactorial interventions were strongly recommended for older adults, at high risk of falling, living at home and, in older adults in care facilities and hospitals, while knowledge/education alone was strongly recommended against for older people at home. Conclusions Based on a systematic review of the evidence, 45 recommendations were formulated regarding non-pharmacological interventions to prevent falls in older adults living at home, in care facilities and in hospitals.

Original languageEnglish
Pages (from-to)413-418
Number of pages6
JournalEuropean Geriatric Medicine
Volume8
Issue number5-6
Early online date21 Sep 2017
DOIs
Publication statusPublished - 1 Nov 2017

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Accidental Falls
Home Care Services
Tai Ji
Independent Living
Nurses
Exercise
Safety
Education
Research

Keywords

  • Evidence
  • Falls
  • GRADE
  • Non-pharmacological interventions
  • Prevention
  • Recommendation

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

Cite this

Non-pharmacological interventions to prevent falls in older patients : Clinical practice recommendations – the SENATOR ONTOP Series. / Rimland, J. M.; Abraha, I.; Dell'Aquila, G.; Cruz-Jentoft, A.; Soiza, R. L.; Gudmundsson, A.; Petrovic, M.; O'Mahony, D.; Cherubini, A.

In: European Geriatric Medicine, Vol. 8, No. 5-6, 01.11.2017, p. 413-418.

Research output: Contribution to journalArticle

Rimland, JM, Abraha, I, Dell'Aquila, G, Cruz-Jentoft, A, Soiza, RL, Gudmundsson, A, Petrovic, M, O'Mahony, D & Cherubini, A 2017, 'Non-pharmacological interventions to prevent falls in older patients: Clinical practice recommendations – the SENATOR ONTOP Series', European Geriatric Medicine, vol. 8, no. 5-6, pp. 413-418. https://doi.org/10.1016/j.eurger.2017.07.013
Rimland, J. M. ; Abraha, I. ; Dell'Aquila, G. ; Cruz-Jentoft, A. ; Soiza, R. L. ; Gudmundsson, A. ; Petrovic, M. ; O'Mahony, D. ; Cherubini, A. / Non-pharmacological interventions to prevent falls in older patients : Clinical practice recommendations – the SENATOR ONTOP Series. In: European Geriatric Medicine. 2017 ; Vol. 8, No. 5-6. pp. 413-418.
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abstract = "Objectives To develop explicit evidence-based recommendations for non-pharmacological interventions to prevent falls in older subjects using the GRADE approach to rate the quality of evidence and the strength of recommendations. Methods A multidisciplinary panel was constituted composed of geriatricians, a research nurse and a clinical epidemiologist. The GRADE approach was used to rate the evidence and to formulate recommendations. Results The critical outcomes were fall rate and number of fallers. Forty-five clinical questions and the associated recommendations were formulated for single, multiple and multifactorial non-pharmacological interventions in three different settings (home, care facilities and hospitals). Seven strong recommendations in favour, and one strong recommendation against, were formulated, all of which were supported by moderate-quality evidence. The remaining 37 clinical questions had weak recommendations. A strong recommendation was formulated in favour of exercise, as a single component, in groups and individually, for community-dwelling older people. Tai Chi was strongly recommended for older adults at risk of falling, living at home. Home safety assessment and modification was strongly recommended for older adults living at home and at high risk of falling. Multifactorial interventions were strongly recommended for older adults, at high risk of falling, living at home and, in older adults in care facilities and hospitals, while knowledge/education alone was strongly recommended against for older people at home. Conclusions Based on a systematic review of the evidence, 45 recommendations were formulated regarding non-pharmacological interventions to prevent falls in older adults living at home, in care facilities and in hospitals.",
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AU - Abraha, I.

AU - Dell'Aquila, G.

AU - Cruz-Jentoft, A.

AU - Soiza, R. L.

AU - Gudmundsson, A.

AU - Petrovic, M.

AU - O'Mahony, D.

AU - Cherubini, A.

N1 - This work was supported by the European Union Seventh Framework program (FP7/2007–2013) under grant agreement no 305930 (SENATOR; http://www.senator-project.eu/) and by the ICT PSP (Policy Support Program) as part of the Competitiveness and Innovation Framework Program of the EU under grant agreement no 325087 (ProFouND; http://profound.eu.com/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2017/11/1

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N2 - Objectives To develop explicit evidence-based recommendations for non-pharmacological interventions to prevent falls in older subjects using the GRADE approach to rate the quality of evidence and the strength of recommendations. Methods A multidisciplinary panel was constituted composed of geriatricians, a research nurse and a clinical epidemiologist. The GRADE approach was used to rate the evidence and to formulate recommendations. Results The critical outcomes were fall rate and number of fallers. Forty-five clinical questions and the associated recommendations were formulated for single, multiple and multifactorial non-pharmacological interventions in three different settings (home, care facilities and hospitals). Seven strong recommendations in favour, and one strong recommendation against, were formulated, all of which were supported by moderate-quality evidence. The remaining 37 clinical questions had weak recommendations. A strong recommendation was formulated in favour of exercise, as a single component, in groups and individually, for community-dwelling older people. Tai Chi was strongly recommended for older adults at risk of falling, living at home. Home safety assessment and modification was strongly recommended for older adults living at home and at high risk of falling. Multifactorial interventions were strongly recommended for older adults, at high risk of falling, living at home and, in older adults in care facilities and hospitals, while knowledge/education alone was strongly recommended against for older people at home. Conclusions Based on a systematic review of the evidence, 45 recommendations were formulated regarding non-pharmacological interventions to prevent falls in older adults living at home, in care facilities and in hospitals.

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