Preventing Elder Falls Before they Happen

Nov 3, 2014, 1:55 PM

Deaths and injuries from falls in people older than age 65 have doubled in the last decade. Last year, 24,000 older people died after a fall and more than two million sustained severe injuries—which can often lead to permanent disability. To find ways to prevent those falls and the injuries, deaths and costs that come with them, earlier this year the National Institutes of Health (NIH) and the Patient-Centered Outcomes Research Institute (PCORI) joined forces on the Falls Injuries Prevention Partnership, which will fund clinical trials at ten U.S. centers over the next five years.

The trials include some implementation of proven fall prevention strategies at the ten research sites. NIH researchers say a key goal is to help change physician behavior about fall prevention, because recent education efforts through conventional medical education channels and other methods have not been very effective.

“With this trial, we will be able to evaluate interventions on a comprehensive and very large scale,” said Richard J. Hodes, MD, director of the National Institute on Aging, which is a division of NIH. “This study will focus on people at increased risk for injuries from falls, the specific care plans that should be implemented—including interventions tailored to individual patients—and how physicians and others in health care and in the community can be involved.”

Each person in the trial will be assessed for their risk of falling, and receive either the current standard of care—information about preventing falls—or individualized care plans first shared with the trial participant’s primary care physician for review, modification and approval. They will include proven fall risk reduction interventions that can be implemented by the research team, physicians and other health care providers, caregivers and community-based organizations.

The trial directors hope to enroll 6,000 adults age 75 and older who have one or more risk factors for falls. The first year of the study is a pilot phase; if the go-ahead is given by NIH and PCORI to proceed with the study after that, enrollment for the full trial will start in June 2015, with participants followed for up to three years. The main goals of the trial are reductions in serious injuries from falls.

“With active input from patients and other stakeholders from the very beginning of this study, we think we can have a major impact, changing practice to make a real difference in the lives of older people,” says PCORI Executive Director Joe Selby, MD, MPH.

The ten trial sites and regions they serve are:

  • Essentia Health, Duluth, Minnesota (Midwest)
  • HealthCare Partners, Torrance, California (Southern California)
  • Johns Hopkins Medicine, Baltimore (Mid-Atlantic)
  • Mount Sinai Health System, New York City (Northeast)
  • Partners HealthCare, Waltham, Massachusetts (Northeast)
  • Reliant Medical Group, Worcester, Massachusetts (Northeast)
  • University of Iowa Health Alliance, Iowa City (Midwest)
  • University of Pittsburgh Medical Center (Mid-Atlantic)
  • University of Texas Medical Branch, Galveston Health (Southwest)
  • University of Michigan, Ann Arbor (Midwest)

Data management and analysis will be coordinated by the Yale School of Public Health.

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This commentary originally appeared on the RWJF New Public Health blog.