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Rehabilitation medicine
Protocol
Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults
  1. Anne-Marie Hill1,
  2. Christopher Etherton-Beer2,
  3. Steven M McPhail3,4,
  4. Meg E Morris5,
  5. Leon Flicker2,
  6. Ronald Shorr6,
  7. Max Bulsara7,
  8. Den-Ching Lee8,9,
  9. Jacqueline Francis-Coad7,10,
  10. Nicholas Waldron11,
  11. Amanda Boudville12,
  12. Terry Haines9,13
  1. 1School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
  2. 2Royal Perth Hospital Unit, WA Centre for Health and Ageing, School of Medicine & Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia
  3. 3Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia
  4. 4Institute of Health and Biomedical Innovation and School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
  5. 5La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University & Healthscope, Melbourne, Victoria, Australia
  6. 6Malcom Randall VA Medical Center, Gainesville, Florida, USA
  7. 7Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  8. 8ACH Group, Health and Community Services, Burwood, Victoria, Australia
  9. 9Physiotherapy Department, Monash University, Melbourne, Victoria, Australia
  10. 10School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
  11. 11Armadale Kelmscott Memorial Hospital, Perth, Western Australia, Australia
  12. 12St John of God Midland Public Hospital, Midland, Western Australia, Australia
  13. 13Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia
  1. Correspondence to Dr Anne-Marie Hill; Anne-Marie.Hill{at}curtin.edu.au

Abstract

Introduction Older adults frequently fall after discharge from hospital. Older people may have low self-perceived risk of falls and poor knowledge about falls prevention. The primary aim of the study is to evaluate the effect of providing tailored falls prevention education in addition to usual care on falls rates in older people after discharge from hospital compared to providing a social intervention in addition to usual care.

Methods and analyses The ‘Back to My Best’ study is a multisite, single blind, parallel-group randomised controlled trial with blinded outcome assessment and intention-to-treat analysis, adhering to CONSORT guidelines. Patients (n=390) (aged 60 years or older; score more than 7/10 on the Abbreviated Mental Test Score; discharged to community settings) from aged care rehabilitation wards in three hospitals will be recruited and randomly assigned to one of two groups. Participants allocated to the control group shall receive usual care plus a social visit. Participants allocated to the experimental group shall receive usual care and a falls prevention programme incorporating a video, workbook and individualised follow-up from an expert health professional to foster capability and motivation to engage in falls prevention strategies. The primary outcome is falls rates in the first 6 months after discharge, analysed using negative binomial regression with adjustment for participant's length of observation in the study. Secondary outcomes are injurious falls rates, the proportion of people who become fallers, functional status and health-related quality of life. Healthcare resource use will be captured from four sources for 6 months after discharge. The study is powered to detect a 30% relative reduction in the rate of falls (negative binomial incidence ratio 0.70) for a control rate of 0.80 falls per person over 6 months.

Ethics and dissemination Results will be presented in peer-reviewed journals and at conferences worldwide. This study is approved by hospital and university Human Research Ethics Committees.

Trial registration number ACTRN12615000784516.

  • GERIATRIC MEDICINE
  • PREVENTIVE MEDICINE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-013931

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    Footnotes

    • Twitter Follow Ronald Shorr @rshorr

    • Contributors A-MH, TH, CE-B and SMM led the trial conception and design and original manuscript drafting and editing. MEM, LF, NW and RS contributed to study conception and design, trial management including data collection, original manuscript drafting, appraisal and editing. A-MH, SMM and TH led the overall trial procedures including intervention delivery protocols, data management and statistical analyses, including economic analyses, and LF, AB, CE-B and NW contributed to overall trial management and led trial management at the sites. JF-C, D-CL and MEM contributed to intervention design and delivery and MB contributed to data management and statistical analyses. All authors appraised the manuscript critically for intellectual content and read and approved the final manuscript.

    • Funding This work is supported by a grant awarded by the National Health and Medical Research Council of Australia (Project grant APP1078918). The funder has no role in the design of the study and will not have any role in its execution, data management, analysis and interpretation or on the decision to submit results for publication. SMM and TH are supported by the National Health and Medical Research Council (of Australia) Career Development awards.

    • Competing interests None declared.

    • Ethics approval This study has been approved by the hospital (the Sir Charles Gairdner Group, number 2015-055) and university (The University of Notre Dame Australia, number 013018F) Human Research Ethics Committees.

    • Provenance and peer review Not commissioned; externally peer reviewed.