Fall Prevention Evidence Report Evidence Table 1. RCTs ...€¦ · Fall Prevention Evidence Report...
16
Fall Prevention Evidence Report Evidence Table 1. RCTs included in Meta-analysis 142 Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes Arm 1: Usual care N entering: 30 N completing: 29 Setting: n/d Provider: n/d % who had at least one fall in 7-18 months 60% # of falls in 12 months 23.49 Arm 2: Endurance training N entering: 25 N completing: 21 Setting: n/d Provider: n/d Arm 3: Strength training N entering: 25 N completing: 22 Setting: n/d Provider: n/d Buchner DM, 1997 ID#617 Study Design: RCT Total Jadad score: 2 Randomized: Yes Randomization appropriate: n/d Double-blind: No Blinding appropriate: n/a Withdrawals/dropouts described: Yes Comorbidities: Fall history Arm 4: Strength training Endurance training N entering: 25 N completing: 24 Setting: n/d Provider: n/d % who had at least one fall in 7-18 months 42% # of falls in 12 months 29.89 for arms 2, 3 & 4 combined (n=61) Arm 1: Control N entering: 117 N completing: 110 Setting: Physician's office Patient's home Provider: Physical therapist Nurses % who had at least one fall in 12 months 54% # of falls in 11.6 months 152 Campbell AJ, 1997 ID#483 Robertson, 2001b ID# 3601 Study Design: RCT Total Jadad score: 3 Randomized: Yes Randomization appropriate: Yes Double-blind: No Blinding appropriate: n/a Withdrawals/dropouts described: Yes Comorbidities: Stroke Fall history Arm 2: Balance Gait General physical activity Strength training N entering: 116 N completing: 103 Setting: Physician's office Patient's home Provider: Physical therapist Nurses % who had at least one fall in 12 months 46% # of falls in 10.5 months 88
Transcript of Fall Prevention Evidence Report Evidence Table 1. RCTs ...€¦ · Fall Prevention Evidence Report...
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
142
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Usual careN entering: 30N completing: 29Setting: n/dProvider: n/d
% who had at least one fall in 7-18 months 60%# of falls in 12 months 23.49
Arm 2: Endurance trainingN entering: 25N completing: 21Setting: n/dProvider: n/d
Arm 3: Strength trainingN entering: 25N completing: 22Setting: n/dProvider: n/d
Buchner DM, 1997ID#617 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 4: Strength trainingEndurance training
N entering: 25N completing: 24Setting: n/dProvider: n/d
% who had at least one fall in 7-18 months 42%# of falls in 12 months 29.89for arms 2, 3 & 4 combined (n=61)
Arm 1: ControlN entering: 117N completing: 110Setting: Physician's office
Patient's homeProvider: Physical therapist
Nurses
% who had at least one fall in 12 months 54%# of falls in 11.6 months 152
Campbell AJ, 1997ID#483
Robertson, 2001bID# 3601
Study Design: RCTTotal Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:StrokeFall history
Arm 2: BalanceGaitGeneral physical activityStrength training
N entering: 116N completing: 103Setting: Physician's office
Patient's homeProvider: Physical therapist
Nurses
% who had at least one fall in 12 months 46%# of falls in 10.5 months 88
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
143
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: ControlN entering: 117N analysis: 110N completing: 62Setting: Patient's homeProvider: n/d
# of falls in 12 months 152Campbell AJ, 1999aID#1504
Gardner, 1998ID#1297
Study Design: RCTTotal Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 2: BalanceGeneral physical activityStrengthReminders
N entering: 116N analysis: 103N completing: 41Setting: Patient's homeProvider: Physical therapist
# of falls in 12 months 88
Arm 1: Usual careN entering: 24N completing: 22Setting: Patient's homeProvider: Nurses
Arm 2: Medication/medication reviewN entering: 24N completing: 18Setting: Patient's homeProvider: Nurses
# of falls in 8.7 months 35
Arm 3: BalanceIndividual counselingStrength training
N entering: 21N completing: 17Setting: Patient's homeProvider: Physical therapist
Nurses
Campbell AJ, 1999bID#1593 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall historyPsychotropic medication
Arm 4: Medication/medication reviewBalanceIndividual counselingStrength training
N entering: 24N completing: 15Setting: Patient's homeProvider: Physical therapist
Nurses
# of falls in 8.7 months 22
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
144
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Usual careN entering: 267N completing: 186Setting: Patient's homeProvider: Volunteers
# of falls in 1 months 36Carpenter GI, 1990ID#443 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:Disability score
Arm 2: Falls risk factor identificationReferral to general practitioner
N entering: 272N completing: 181Setting: Patient's homeProvider: Volunteers
# of falls in 1 months 12
Arm 1: Usual careN entering: 13N completing: Not reportedSetting: n/dProvider: n/d
% who had at least one fall in 6 months 23%Cerny K, 1998ID#717 Study Design: RCT
Total Jadad score: 1Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: No
Comorbidities:n/d
Arm 2: BalanceGeneral physical activityStrength
N entering: 15N completing: Not reportedSetting: n/dProvider: n/d
% who had at least one fall in 6 months 20%
Arm 1: Usual careN entering: 213N completing: 163Setting: n/dProvider: n/d
% who had at least one fall in 12 months 52%# of falls in 12 months 510
Close J, 1999ID#1524 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 2: Environmental modificationFalls risk factor identificationIndividual counseling
N entering: 184N completing: 141Setting: Patient's home
Day hospitalProvider: Physicians
Therapists
% who had at least one fall in 12 months 32%# of falls in 12 months 183
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
145
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Usual careN entering: 73N analysis: 50N completing: 49Setting: n/dProvider: n/d
% who had at least one fall in 12 months 38%Coleman EA, 1999ID#1510 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 2: Medication/medication reviewIndividual counselingGroup counselingStaff training
N entering: 96N analysis: 52N completing: 78Setting: Physicians officeProvider: Physicians
NursesPharmacists
Social workers
% who had at least one fall in 12 months 44%
Arm 1: Usual careN entering: 38N completing: 27Setting: Falls clinicProvider: n/a
# of falls in 6 months 127Crome P, 2000ID# 3633 Study design: RCT
Total Jadad score: 1Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: No
Comorbidities:Fall history
Arm 2: BalanceGeneral physical activityIndividual counseling
N entering: 40N completing: 29Setting: Falls clinicProvider: Nurses
# of falls in 6 months 122
Arm 1: Usual careN entering: 266N completing: 190Setting: n/dProvider: n/d
% who had at least one fall in 12 months 45%Cumming RG, 1999ID#1699 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:VisionStrokeFall history
Arm 2: Environmental modificationFalls risk factor identificationReminders
N entering: 264N completing: 198Setting: Patient's homeProvider: Physical therapist
% who had at least one fall in 12 months 36%
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
146
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: ControlIndividual counseling
N entering: 84N completing: 50Setting: n/dProvider: Nurses
% who had at least one fall in 12 months 36%# of falls in 24 months 54
Ebrahim S, 1997ID#1204 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 2: General physical activityIndividual counseling
N entering: 81N completing: 52Setting: n/dProvider: Nurses
% who had at least one fall in 12 months 42%# of falls in 24 months 71
Arm 1: ControlN entering: 14N completing: 11Setting: Patient's HomeProvider: Researcher
Student assistant
# of falls in 9 months 5El-Faizy, 1994ID#583 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/d
Withdrawals/dropouts described: Yes
Comorbidities:Fall History
Focus population:HispanicLow-income
Same population as Reinsch, 1992Arm 2: Falls risk factor identification
Individual CounselingN entering: 14N completing: 13Setting: Patient's HomeProvider: Researcher
Student assistant
# of falls in 9 months 8
Arm 1: Usual careN entering: 123N completing: 95Setting: Patient's homeProvider: n/d
% who had at least one fall in 12 months 23%Fabacher D, 1994ID#444 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:StrokeFall history
Focus population:Veterans
Arm 2: Environmental modificationMedication/medication reviewIndividual counselingFeedbackPhysical exam/geriatric assessment
N entering: 131N completing: 100Setting: Patient's homeProvider: Nurses
Social workersVolunteers
Physician assistants
% who had at least one fall in 12 months 14%
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
147
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: ControlN entering: 26N completing: 26Setting: Nursing HomeProvider: Research Staff
# of falls in 18 months 72
Arm 2: Strength TrainingN entering: 25N completing: 25Setting: Nursing HomeProvider: n/d
Arm 3 : Nutritional SupplementN entering: 24N completing: 22Setting: Nursing HomeProvider: Nurses
Fiatarone MA, 1993ID#528 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/a
Withdrawals/dropouts described: Yes
Comorbidities:Frailty
Arm 4: Strength TrainingNutritional Supplement
N entering: 25N completing: 25Setting: Nursing HomeProvider: Nurses
# of falls in 18 months 58
Arm 1: ControlN entering: 50N completing: 50Setting: n/dProvider: Nurses
# of falls in 6 months 105Gallagher EM, 1996ID#578 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 2: Falls risk factorIndividual counselingFeedbackBehavior modification
N entering: 50N completing: 50Setting: n/dProvider: Nurses
# of falls in 6 months 85
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
148
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Falls risk factorIndividual counseling
N entering: 1571N completing: Not reportedSetting: Patient's homeProvider: Project staff member
# of falls in 22.8 months 2084Hornbrook MC, 1994ID#445 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall historyChronic conditionsDepression
Arm 2: Environmental modificationFalls risk factor identificationGeneral physical activityIndividual counselingGroup counselingStrength trainingFinancial assistance
N entering: 1611N completing: 1455Setting: Patient's home
HMO research centerProvider: Physical therapist
Health behaviorist
# of falls in 22 months 1730
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
149
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Usual careN entering: 208N completing: 167Setting: Residential care facilityProvider: n/a
% who had at least one fall in 8.5 months 56%# of falls in 7.1 months 346
Jensen J, 2002ID# 3654 Study design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:GaitVisionStrokeFall historyParkinson’s DiseasePrevious fracture Arm 2: Assistive device
BalanceEnvironmental modificationFalls risk factor identificationGaitGeneral physical activityMedication/medication reviewStrength trainingHip protectorsStaff education and guidance
N entering: 194N analysis 188N completing: 157Setting: Residential care facilityProvider: Physicians
TherapistsNurses
% who had at least one fall in 8.5 months 44%# of falls in 7.1 months 273
Arm 1: Usual careN entering: 97N analysis: 94N completing: 76Setting: n/dProvider: n/d
% who had at least one fall in 12 months 35%# of falls in 12 months 59
Lord SR, 1995ID#446 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall historyMedical conditionDrugs Interactions
Arm 2: BalanceGeneral physical activityStrengthRelaxation
N entering: 100N analysis: 75N completing: 75Setting: Community centerProvider: n/d
% who had at least one fall in 12 months 35%# of falls in 12 months 40
Arm 1: Usual careN entering: 69N completing: 69Setting: Rehabilitation hospitalProvider: Nurses
% who had at least one fall in 12 months 30%Mayo NE, 1994ID#448 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:StrokeFall history
Arm 2: Reminder braceletN entering: 65N completing: 65Setting: Rehabilitation hospitalProvider: Nurses
% who had at least one fall in 12 months 42%
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
150
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Calcium supplementN entering: 60N completing: 48Setting: n/dProvider: n/d
# of falls in 24 months 31McMurdo ME, 1997ID#449 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:n/d
Arm 2: General physical activityCalcium supplement
N entering: 58N completing: 44Setting: University classProvider: n/d
# of falls in 24 months 15
Arm 1: ControlN entering: 56N completing: 38Setting: n/dProvider: n/d
% who had at least one fall in a 7-12 monthperiod following a 6 month intervention 58%# of falls in 5.2 months 67
McMurdo ME, 2000ID#1984 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:n/d
Arm 2: BalanceFalls risk factor identificationMedication/medication reviewVision improvement screening
N entering: 77N completing: 52Setting: n/dProvider: Clinician
% who had at least one fall in a 7-12 monthperiod following a 6 month intervention 43%# of falls in 5.2 months 68
Arm 1: Control GroupCounseling
N entering: 38N completing: 31Setting: Community centerProvider: Instructors
Assistants
% who had at least one fall in 12 months 45%McRae PG, 1994ID#2027 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 2: BalanceGeneral physical activityGroup counselingStrength training
N entering: 42N completing: 28Setting: Community centerProvider: Exercise instructors
Assistants
% who had at least one fall in 12 months 36%
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
151
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: BalanceFalls risk factor identificationGroup counseling
N entering: 52N completing: 34Setting: n/dProvider: Physicians
Therapists
# of falls in 6 months 65Means KM, 1996ID#450
Study Design: RCTTotal Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:BalanceFall historyOther medical condition
Focus population:Veterans
Arm 2: BalanceFalls risk factor identificationGroup counselingPractice in obstacle course
N entering: 47N completing: 30Setting: n/dProvider: Physicians
Therapists
# of falls in 6 months 45
Arm 1: ControlN entering: Not reportedN completing: 38Setting: Patient's homeProvider: n/d
% who had at least one fall in 12 months 44%Millar AM, 1999ID# 3617 Study design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:n/d
Arm 2: Environmental modificationFall risk factor identificationGeneral physical activityMedication/medication reviewVisionMedical risk factors identificationOrthostatic blood pressure
N entering: Not reportedN completing: 46Setting: Patient's homeProvider: n/d
% who had at least one fall in 12 months 57%
Arm 1: ControlN entering: 97N completing: 88Setting: Nursing homeProvider: n/d
# of falls in 4 months 60Mulrow CD, 1994ID#451 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:VisionStroke
Focus population:Nursing home
Arm 2: Assistive deviceBalanceGaitGeneral physical activityStrength trainingTailored physical therapy
N entering: 97N completing: 92Setting: Nursing homeProvider: Physical therapist
# of falls in 4 months 79
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
152
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Usual careN entering: 115N completing: 100Setting: n/dProvider: n/d
% who had at least one fall in 12 months 33%Pereira MA, 1998ID#1533
Pereira MA , 1996ID# 3618
Study Design: RCTTotal Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:Healthy elderly
Arm 2: General physical activityN entering: 114N completing: 96Setting: n/dProvider: n/d
% who had at least one fall in 12 months 27%
Arm 1: ControlN entering: 50N completing: 42Setting: Community centerProvider: n/d
% who had at least one fall in 12 months 40%
Arm 2: BalanceGeneral physical activityStrength
N entering: 57N completing: 44Setting: Community centerProvider: n/d
% who had at least one fall in 12 months 50%
Arm 3: Falls risk factor identificationGroup counselingRelaxation techniquesVideo game playing
N entering: 51N completing: 37Setting: Community centerProvider: n/d
% who had at least one fall in 12 months 46%
Reinsch S, 1992ID#491 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Focus population:HispanicLow-income
Same population as El-Faizy, 1994
Arm 4: Falls risk factor identificationGeneral physical activityGroup counselingRelaxation techniqueVideo game playing
N entering: 72N completing: 61Setting: Community centerProvider: n/d
% who had at least one fall in 12 months 54%
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
153
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1 : Usual careN entering: 119N completing: 98Setting: n/dProvider: n/a
# of falls in 12 months 109Robertson MC, 2001aID#3260 Study design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:StrokeFall historyParkinson’s Disease
Arm 2 : BalanceGeneral physical activityIndividual counselingStrength training
N entering: 121N completing: 113Setting: Patient's homeProvider: Nurses
# of falls in 12 months 80
Arm 1: Usual careN entering: 81N completing: 81Setting: Nursing homeProvider: Nurses
% who had at least one fall in 12 months 75%Rubenstein LZ, 1990ID#492 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: YesDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: No
Comorbidities:BalanceVisionFall history
Focus population:Nursing home Arm 2: Falls risk factor identification
N entering: 79N completing: 79Setting: Nursing homeProvider: Nurses
% who had at least one fall in 12 months 71%
Arm 1: Usual care Strength trainingN entering: 28N completing: 27Setting: n/dProvider: n/d
# of falls in 3 months 14Rubenstein LZ, 2000ID#1988 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:BalanceGaitStrokeFall history
Focus population:Veterans
Arm 2: BalanceGeneral physical activityStrength
N entering: 31N completing: 28Setting: n/dProvider: Graduate student
# of falls in 3 months 13
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
154
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: ControlGroup counseling
N entering: 15N completing: 15Setting: n/dProvider: n/d
# of falls in 3 months 6
Arm 2: Group counselingN entering: 15N completing: 16Setting: n/dProvider: Nurses
# of falls in 3 months 4(arms 2 and 3 combined)
Ryan JW, 1996ID#681 Study Design: RCT
Total Jadad score: 1Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: No
Comorbidities:VisionFall history
Focus population:African-AmericansLow-income
Arm 3: Individual counselingN entering: 15N completing: 14Setting: n/dProvider: Nurses
Arm 1: Usual careN entering: 266N analysis: 258N completing: 266Setting: n/dProvider: n/a
# of falls in 12 months 324Salkeld G, 2000ID#3094 Study Design: RCT
Total Jadad score: 1Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: No
Comorbidities:Fall history
Arm 2: Environmental modificationFalls risk factor identification
N entering: 264N analysis: 257N completing: 264Setting: Patient's homeProvider: Physical therapist
# of falls in 12 months 226
Arm 1: Usual careN entering: 7N completing: 7Setting: Nursing homeProvider: n/a
# of falls in 6 months 12Schoenfelder, 2000ID# 3624 Study design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:BalanceGaitFall history
Focus population:Nursing home Arm 2: General physical activity
Strength trainingN entering: 9N completing: 9Setting: Nursing homeProvider: n/d
# of falls in 6 months 42
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
155
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Group counselingIncreased risk awareness
N entering: 63N completing: 63Setting: n/dProvider: n/d
Incidence rate (persons) 4.00/100pm# of falls in 12 months 75.5pm=person months of observation
Arm 2: General physical activityGroup counselingIncreased risk awareness
N entering: 69N completing: 69Setting: n/dProvider: n/d
Incidence rate (persons) 3.43/100pm# of falls in 12 months 74.7pm=person months of observation
Arm 3: Environmental modificationFalls risk factor identificationGeneral physical activityGroup counselingIncreased risk awareness
N entering: 61N completing: 60Setting: n/dProvider: n/d
Incidence rate (persons) 3.62/100pmpm=person months of observation
Steinberg M, 2000ID#2523
Peel N, 2000ID# 3607
Study Design: RCTTotal Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:Fall history
Arm 4: Environmental modificationFalls risk factor identificationGeneral physical activityIndividual counselingGroup counselingIncreased risk awareness
N entering: 59N completing: 57Setting: n/dProvider: n/d
Incidence rate (persons) 3.88/100pmpm=person months of observation
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
156
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: ControlFalls risk factor identification
N entering: 148N completing: 144Setting: Patient's homeProvider: Therapists
NursesSocial workers
% who had at least one fall in 12 months 47%# of falls in 12 months 164
Tinetti ME, 1994ID#494Rizzo JA, 1996ID# 418
Tinetti ME, 1996ID#497
Study Design: RCTTotal Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:BalanceGaitVisionFall historyChronic conditions
Arm 2: BalanceEnvironmental modificationFalls risk factor identificationGaitMedication/medication reviewIndividual counselingStrength trainingBehavioral interventions
N entering: 153N completing: 147Setting: Patient's homeProvider: Physical therapist
Nurses
% who had at least one fall in 12 months 35%# of falls in 12 months 94
Arm 1: Usual careN entering: 157N analysis: 123N completing: 115Setting: n/dProvider: n/a
% who had at least one fall in 12 months 44%van Haastregt J, 2000ID#3091 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:GaitFall history
Focus population:Low-income
Arm 2: Environmental modificationFalls risk factor identificationMedication/medication reviewIndividual counseling
N entering: 159N analysis: 129N completing: 120Setting: Patient's homeProvider: Nurses
% who had at least one fall in 12 months 50%
Fall Prevention Evidence ReportEvidence Table 1. RCTs included in Meta-analysis
157
Study ID Study Design/ Quality Characteristics of Study Population Intervention Outcomes
Arm 1: Usual careN entering: 607N completing: Not reportedSetting: n/dProvider: n/d
% who had at least one fall in 12 months 37%
Arm 2: Environmental modificationFalls risk factor identificationGeneral physical activityMedication/medication reviewIndividual counselingVisionAlcohol use/treatmentHearing evaluationBehavioral intervention
N entering: 635N completing: Not reportedSetting: n/dProvider: Nurses
FamilyEducator
Volunteer
% who had at least one fall in 12 months 28%
Wagner EH, 1994ID#502 Study Design: RCT
Total Jadad score: 2Randomized: YesRandomization appropriate: n/dDouble-blind: n/dBlinding appropriate: n/dWithdrawals/dropouts described: Yes
Comorbidities:VisionFall historyAlcoholRestrictive activity
Arm 3: Individual counselingPreventive services
N entering: 317N completing: Not reportedSetting: n/dProvider: Nurses
% who had at least one fall in 12 months 30%
Arm 1: ControlMedication/medication reviewGroup counseling
N entering: 64N completing: 61Setting: n/dProvider: Nurses
Researcher
# of falls in 5.39 months 77
Arm 2: Balance trainingN entering: 64N completing: 60Setting: n/dProvider: n/d
# of falls in 5.39 months 76
Wolf SL, 1996ID#503 Study Design: RCT
Total Jadad score: 3Randomized: YesRandomization appropriate: YesDouble-blind: NoBlinding appropriate: n/aWithdrawals/dropouts described: Yes
Comorbidities:VisionFall history
Arm 3: Tai chiN entering: 72N completing: 66Setting: n/dProvider: n/d
# of falls in 5.62 months 56
