Abstract
Pérula LA, Varas-Fabra F, Rodríguez V, Ruiz-Moral R, Fernández JA, González J, Pérula
CJ, Roldán AM, de Dios C, and the EPICA Study Collaborative Group. Effectiveness of
a multifactorial intervention program to reduce falls incidence among community-living
older adults: a randomized controlled trial.
Objective
To determine the effectiveness of a multifactorial intervention program to prevent
falls among older adults as compared with a brief intervention.
Design
Randomized controlled trial.
Setting
Eleven health centers located in Córdoba, Spain.
Participants
People over 70 years old (N=404), who are residents in the community.
Interventions
The centers were randomized to either 1 of the 2 groups: intervention group (IG),
of a multifactorial nature (individual advice, information leaflet, physical exercise
workshop, and home visits), or control group (CG) (brief individual advice and information
leaflet).
Main Outcome Measures
Fall rates and time until the fall; estimates of the relative and absolute risk of
falls; and survival analysis and Cox regression.
Results
Of the patients recruited, 133 were in the IG and 271 were in the CG. Around 33% in
the IG and 30.25% in the CG had had a fall in the previous year (P=.56). After 12 months, the fall incidence rate was 17.29% in the IG and 23.61% in
the CG (relative risk=0.73; 95% confidence interval [CI], 0.48–1.12; P=.146). Around 60% of the IG patients said they had increased the time spent on physical
activity. In the IG, the incidence of falls at home was 27.5% compared with 49.3%
in the CG (P=.04). Being a woman (odds ratio [OR]=1.62; 95% CI, 1.03–2.54), having a history of
falls (OR=1.15; 95% CI, 1.05–1.26), suffering acute health problems (OR=2.19; 95%
CI, 1.09–4.40), and doing moderate exercise (OR=1.91; 95% CI, 1.08–3.38) were found
as factors associated with a higher risk of falls.
Conclusions
Although the reduction of falls in the IG was nearly halved, and after the intervention
there was a significant reduction in the number of falls at these patients' homes,
the multifactorial intervention program is no more effective than the brief intervention
to reduce the overall risk of falls.
Key Words
List of Abbreviations:
CG (control group), IG (intervention group), PC (primary care), POMA (Performance Oriented Mobility Assessment)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 17, 2012
Footnotes
Supported by the Health Department of the Andalusian Region Government, the Andalusian Society of Family and Community Medicine, and the Spanish Society of Family and Community Medicine (financial aid to PhD dissertations projects).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
The EPICA (in Spanish: Eficacia de un Programa de Intervención para la prevención de CAídas) Study Collaborative Group includes the following: Jesús Albert, MD, Healthcare Center of Guadalquivir (SAS), Córdoba, Spain; Miriam Amián, MD, Healthcare Center at Zambra (SAS), Córdoba, Spain; Carmen Amo, MD, Healthcare Center of Levante-norte (SAS), Córdoba, Spain; Carmen Arias, MD, Healthcare Center of Occidente (SAS), Córdoba, Spain; Rafael Bejarano, MD, Healthcare Center of Levante-norte (SAS), Córdoba, Spain; Estrella Castro, MD, Healthcare Center of Occidente (SAS), Córdoba, Spain; Rafael del Pozo, MD, Healthcare Center of Occidente (SAS), Córdoba, Spain; Miguel A Fernández, MD, Healthcare Center at Cabra (SAS), Córdoba, Spain; Manuel A García, MD, Healthcare Center of Bujalance (SAS), Córdoba, Spain; Leonor García-de-Vinuesa, MD, Healthcare Center at La Carlota (SAS), Córdoba, Spain; Ana L Luque, MD, Healthcare Center of Bujalance (SAS), Córdoba, Spain; Antonia Martínez, RN, Healthcare Center of Fuensanta (SAS), Córdoba, Spain; Carlos Ortega, MD, Healthcare Center at Pozoblanco (SAS), Córdoba, Spain; Alfredo Ortiz, MD, Healthcare Center at La Carlota (SAS), Córdoba, Spain; Jorge Martínez, MD, Healthcare Center of Occidente (SAS), Córdoba, Spain; Ana Pérez, RN, Healthcare Center of Fuensanta (SAS), Córdoba, Spain; Eva M Sánchez, MD, Healthcare Center at Doña Mencía (SAS), Córdoba, Spain; Francisco Sierra, MD, Healthcare Center of Fuensanta (SAS), Córdoba, Spain; Juan Solís, MD, Healthcare Center of Levante-norte (SAS), Córdoba, Spain; Maria L Zorrilla, MD, Healthcare Center at Zambra (SAS), Córdoba, Spain.
Clinical Trial Registration No.: NCT01279525.
Reprints are not available from the author.
In-press corrected proof published online on Jul 20, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
