Falls prevention in residential care homes: a randomised controlled trial.

OBJECTIVE

to determine the effect of risk factor modification and balance exercise on falls rates in residential care homes.

DESIGN

cluster randomised controlled trial.

PARTICIPANTS

196 residents (aged 60 years or over) in 20 residential care homes were enrolled (38% response rate). Homes were randomly allocated to intervention and control arms. A total of 102 residents were consigned to the intervention arm and 94 to the control arm.

INTERVENTION

a multifactorial falls prevention programme including 3 months gait and balance training, medication review, podiatry and optometry.

MAIN OUTCOME MEASURES

number of falls/recurrent falls per person, number of medications per person, and change in Tinetti gait and balance measure.

RESULTS

in the intervention group there was a mean of 2.2 falls per resident per year compared with 4.0 in the control group; this failed to reach statistical significance (P = 0.2) once the intra-cluster correlation (ICC, 0.10) had been accounted for. Several risk factors were reduced in the intervention arm.

CONCLUSIONS

falls risk factor reduction is possible in residents of care homes. A modest reduction in falls rates was demonstrated but this failed to reach statistical significance.