Ueda Tetsuya, Higuchi Yumi, Imaoka Masakazu, Todo Emiko, Kitagawa Tomomi, Ando Suguru
Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino City, Osaka, Japan.
Section of Cohort Study for Longevity, Department of Preventive Gerontology, National Center for Geriatrics and Gerontology, Moriokacho, Obu City, Aichi, Japan.
Arch Gerontol Geriatr. 2017 Jul;71:9-13. doi: 10.1016/j.archger.2017.02.010. Epub 2017 Feb 17.
To investigate the effect of a tailored education program using home floor plans on falls prevention in discharged older patients.
A single-center, parallel, pragmatic, pilot randomized controlled trial with equal allocation to the intervention and control groups.
Discharged hospital patients were followed-up in their home settings.
All discharged orthopedic patients aged ≥65 years who experienced ≥1 fall(s) in the past year (n=60).
Both groups received standard care (exercises) and the intervention group also received a tailored education program for falls prevention using home floor plans.
Falls and near-falls at the participants' homes using a 1-month fall calendar during the 1-month period after discharge. The evaluators were blinded at the baseline assessment.
Nine participants were withdrawn from the study, leaving 51 of 60 (85%) participants for the final analyses. No falls occurred in the intervention group (n=25) during follow-up. However, 2 participants (7.7%) fell in the control group (n=26). Near-falls were reported by 7 participants (28.0%) in the intervention group and 13 participants (50.0%) in the control group. The intervention group had 75% less near-falls compared with the control group, as assessed using a Cox proportional hazards model (hazard ratio, 0.25; 95% confidence interval, 0.09-0.75).
The tailored education program using home floor plans at the hospital was effective for reducing falls and near-falls among discharged orthopedic patients. Registration of clinical trials: This study was registered with the Research Ethics Committee of University Hospital Medical Information Network (UMIN) Center (000018201).
探讨使用家庭平面图的定制教育计划对出院老年患者预防跌倒的效果。
一项单中心、平行、实用的试点随机对照试验，干预组和对照组分配人数相等。
对出院的医院患者在其家中进行随访。
所有年龄≥65岁、过去一年中经历过≥1次跌倒的出院骨科患者（n = 60）。
两组均接受标准护理（锻炼），干预组还接受使用家庭平面图的定制跌倒预防教育计划。
出院后1个月内，使用1个月跌倒日历记录参与者家中的跌倒和险些跌倒情况。评估人员在基线评估时不知情。
9名参与者退出研究，最终分析纳入60名参与者中的51名（85%）。随访期间干预组（n = 25）未发生跌倒。然而，对照组（n = 26）中有2名参与者（7.7%）跌倒。干预组有7名参与者（28.0%）报告险些跌倒，对照组有13名参与者（50.0%）报告险些跌倒。使用Cox比例风险模型评估，干预组的险些跌倒发生率比对照组低75%（风险比，0.25；95%置信区间, 0.09 - 0.75）。
医院使用家庭平面图的定制教育计划对减少出院骨科患者的跌倒和险些跌倒有效。临床试验注册情况：本研究已在大学医院医学信息网络（UMIN）中心研究伦理委员会注册（000018201）。
