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Little evidence for fall prevention programmes

By Lilian Anekwe

A new review has questioned the widespread use of fall prevention programmes in primary and community care, and found little evidence that they work.

An assessment of targeted interventions programmes, recommended by both NICE and the National Service Framework for Older People, has found that they do not prevent falls nor reduce the number of fall related injuries in the elderly.

The review of 19 trials 'of variable methodological quality', involving 6,397 patients, found no strong evidence of benefit from fall prevention programmes.

There was no clear reduction in the number of people having at least one fall, the number having fall-related injuries, or attendance at accident and emergency or admissions to hospital following a fall.

The authors of the paper published online in the BMJ today, did suggest that more intense interventions that actively provide treatments, such as exercise training programmes or physiotherapy, may be more effective than those that provide only knowledge and referral.

Lead author Dr Simon Gates, principal research fellow at the University of Warwick clinical trials unit, said the analysis suggested that 'any benefits from this type of intervention might be smaller than previously supposed.'

Dr Gates also called for more trials to determine whether intervention programmes have a positive impact on other outcomes, such as reducing the rate of falls or injuries.

Dr Steve Iliffe, a member of the NICE guideline development group on falls in the elderly, agreed that the paper was an 'important and timely reminder' of the need for more Government funding for research in this area.

Dr Iliffe – co-director of the UCL centre for ageing and population studies – told Pulse:

'There's no need for GPs to stop referring or withdraw their patients from fall prevention programmes. But for GPs acting as commissioners, there's no evidence in this study to say that if you haven't got a programme in place, you need one.'

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