Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial

OBJECTIVE: To assess the effectiveness of a targeted, multiple intervention falls prevention programme in reducing falls and injuries related to falls in a subacute hospital. DESIGN: Randomised controlled trial of a targeted multiple intervention programme implemented in addition to usual care compared with usual care alone. SETTING: Three subacute wards in a metropolitan hospital specialising in rehabilitation and care of elderly patients. PARTICIPANTS: 626 men and women aged 38 to 99 years (average 80 years) were recruited from consecutive admissions to subacute hospital wards. INTERVENTION: Falls risk alert card with information brochure, exercise programme, education programme, and hip protectors. MAIN OUTCOME MEASURES: Incidence rate of falls, injuries related to falls, and proportion of participants who experienced one or more falls during their stay in hospital. RESULTS: Participants in the intervention group (n = 310) experienced 30% fewer falls than participants in the control group (n = 316). This difference was significant (Peto log rank test P = 0.045) and was most obvious after 45 days of observation. In the intervention group there was a trend for a reduction in the proportion of participants who experienced falls (relative risk 0.78, 95% confidence interval 0.56 to 1.06) and 28% fewer falls resulted in injury (log rank test P = 0.20). CONCLUSIONS: A targeted multiple intervention falls prevention programme reduces the incidence of falls in the subacute hospital setting.