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Titolo:
A RANDOMIZED TRIAL OF A CONSULTATION SERVICE TO REDUCE FALLS IN NURSING-HOMES
Autore:
RAY WA; TAYLOR JA; MEADOR KG; THAPA PB; BROWN AK; KAJIHARA HK; DAVIS C; GIDEON P; GRIFFIN MR;
Indirizzi:
VANDERBILT UNIV,SCH MED,DEPT PREVENT MED,DIV PHARMACOEPIDEMIOL,221 KIRKLAND HALL NASHVILLE TN 37232 BELMONT UNIV,DEPT OCCUPAT THERAPY NASHVILLE TN 00000 DUKE UNIV,VET AFFAIRS MED CTR,DEPT PSYCHIAT DURHAM NC 00000
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 7, volume: 278, anno: 1997,
pagine: 557 - 562
SICI:
0098-7484(1997)278:7<557:ARTOAC>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIP FRACTURE; RISK-FACTORS; PSYCHOTROPIC-DRUGS; ELDERLY PATIENTS; RESIDENTS; INJURIES; PREVENTION; COMMUNITY; PROGRAM; LONG;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
40
Recensione:
Indirizzi per estratti:
Citazione:
W.A. Ray et al., "A RANDOMIZED TRIAL OF A CONSULTATION SERVICE TO REDUCE FALLS IN NURSING-HOMES", JAMA, the journal of the American Medical Association, 278(7), 1997, pp. 557-562

Abstract

Context.-Falls are a major health problem in nursing homes, but no interventions have been shown to prevent falls in nursing home residents. Objective.-To evaluate an intervention program designed to prevent falls and associated injuries in high-risk nursing home residents. Design.-Randomized controlled trial. Setting and Participants.-Seven pairsof middle Tennessee nursing homes with 1 facility in each pair randomly assigned to the intervention. Facilities had 482 (261 control, 221 intervention) residents who qualified for the study because they had high risk of falls and a potential safety problem that could be addressed by the intervention. Intervention.-Comprehensive structured individual assessment with specific safety recommendations that targeted suboptimal practices for environmental and personal safety, wheelchair use, psychotropic drug use, and transferring and ambulation. Facility staff were encouraged to implement the individual recommendations and to improve overall facility safety. Main Outcome Measures.-The mean proportion of recurrent fallers and incidence rate of injurious falls in the facility in the year following the intervention. Results.-The mean proportion of recurrent fallers in intervention facilities (43.8%) was 19.1% (95% confidence interval, 2.4%-35.8%) lower than that in controlfacilities (54.1%, P=.03). Intervention facilities had a nonsignificant trend toward a lower mean rate of injurious falls (13.7 vs 19.9 per100 person-years, reduction of 31.2%, P=.22). Subgroup analyses suggested greatest benefits for residents for whom the recommended interventions were carried out or who had 3 or more falls in the preceding year. Conclusion.-The high rate of falls and related injuries in nursing homes should not be viewed as inevitable, but as outcomes that can be substantially improved through structured safety programs.

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Documento generato il 04/04/20 alle ore 09:05:01