Clinical Interventions in Aging (Jun 2013)

Effectiveness of preventive home visits in reducing the risk of falls in old age: a randomized controlled trial

  • Luck T,
  • Motzek T,
  • Luppa M,
  • Matschinger H,
  • Fleischer S,
  • Sesselmann Y,
  • Roling G,
  • Beutner K,
  • König HH,
  • Behrens J,
  • Riedel-Heller SG

Journal volume & issue
Vol. Volume 8
pp. 697 – 702

Abstract

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Tobias Luck,1,2,* Tom Motzek,3,* Melanie Luppa,1 Herbert Matschinger,1 Steffen Fleischer,4 Yves Sesselmann,4 Gudrun Roling,5 Katrin Beutner,4 Hans-Helmut König,6 Johann Behrens,4 Steffi G Riedel-Heller11Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany; 2Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany; 3Technical University Dresden, Dresden, Germany; 4Institute of Nursing and Health Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany; 5Faculty of Health, Witten/Herdecke University, Witten, Germany; 6Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany*These authors contributed equally to this work Background: Falls in older people are a major public health issue, but the underlying causes are complex. We sought to evaluate the effectiveness of preventive home visits as a multifactorial, individualized strategy to reduce falls in community-dwelling older people.Methods: Data were derived from a prospective randomized controlled trial with follow-up examination after 18 months. Two hundred and thirty participants (≥80 years of age) with functional impairment were randomized to intervention and control groups. The intervention group received up to three preventive home visits including risk assessment, home counseling intervention, and a booster session. The control group received no preventive home visits. Structured interviews at baseline and follow-up provided information concerning falls in both study groups. Random-effects Poisson regression evaluated the effect of preventive home visits on the number of falls controlling for covariates.Results: Random-effects Poisson regression showed a significant increase in the number of falls between baseline and follow-up in the control group (incidence rate ratio 1.96) and a significant decrease in the intervention group (incidence rate ratio 0.63) controlling for age, sex, family status, level of care, and impairment in activities of daily living.Conclusion: Our results indicate that a preventive home visiting program can be effective in reducing falls in community-dwelling older people.Keywords: falls, randomized controlled trial, home visits, prevention, evaluation

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