Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Noord-Brabant, Netherlands.
NIVEL, Utrecht, Netherlands.
Clin Interv Aging. 2020 Sep 9;15:1625-1636. doi: 10.2147/CIA.S254864. eCollection 2020.
Falls are an increasing problem among older people. There are several evidence-based interventions available to prevent falls. However, these are not always well implemented in the primary care setting. General practitioners (GPs) are often the first point of contact for health issues, making them the designated professionals for providing falls prevention. Because GPs are often unaware which patients have a high fall risk and patients themselves do not always know they have a high fall risk, this study aims to evaluate the implementation of a targeted fall risk screening strategy among independently living, frail older people in the primary care setting.
The targeted fall risk screening strategy used in this study consists of tools for screening high fall risk and for identifying the underlying cause(s) of the high fall risk, an accredited training course in falls prevention for professionals, and service provision by certified physio- and exercise therapists who are able to offer evidence-based falls prevention interventions. This targeted fall risk screening strategy will be implemented in the primary care setting and evaluated at the level of the GP practice and at the level of the patient by using the RE-AIM model of Glasgow et al. In a pre-posttest design, data will be collected of the total number of frail older people who are screened, referred and enrolled for fall-preventive care. Furthermore, barriers and facilitators of the implementation of the fall risk screening strategy will be identified by conducting focus groups and interviews with the care providers and frail older patients. Additionally, the influence of the falls prevention interventions on frail older patients will be evaluated by using a pre-posttest design with a 12-month follow-up period during which data are collected regarding patients' stability, mobility, strength, balance, self-efficacy, health status, and daily activities.
This study is approved by the Medical Ethics Committee Brabant, the Netherlands (NL61582.028.17/ P1732) and registered at the Netherlands Trial Register, NL7917.
老年人的跌倒问题日益严重。有几种基于证据的干预措施可用于预防跌倒。然而，这些干预措施在初级保健环境中并不总是得到很好的实施。全科医生（GP）通常是健康问题的第一接触点，使他们成为提供跌倒预防的指定专业人员。由于 GP 通常不知道哪些患者有高跌倒风险，而患者本身并不总是知道自己有高跌倒风险，因此本研究旨在评估在初级保健环境中针对独立生活的体弱老年人实施有针对性的跌倒风险筛查策略。
本研究中使用的有针对性的跌倒风险筛查策略包括用于筛查高跌倒风险和识别高跌倒风险的潜在原因的工具、针对专业人员的跌倒预防认证培训课程以及由认证的物理治疗师和运动治疗师提供的服务，他们能够提供基于证据的跌倒预防干预措施。该有针对性的跌倒风险筛查策略将在初级保健环境中实施，并使用格拉斯哥等人的 RE-AIM 模型在 GP 实践层面和患者层面进行评估。在前后测试设计中，将收集接受筛查、转诊和参加防跌倒护理的体弱老年人的总数。此外，通过对护理提供者和体弱老年人进行焦点小组和访谈，确定实施跌倒风险筛查策略的障碍和促进因素。此外，还将使用前后测试设计并结合 12 个月的随访期来评估跌倒预防干预措施对体弱老年人的影响，在此期间收集有关患者稳定性、移动性、力量、平衡、自我效能、健康状况和日常活动的数据。
本研究得到荷兰布拉班特省医学伦理委员会（NL61582.028.17/P1732）的批准，并在荷兰试验注册处（NL7917）注册。
