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

<b>Objective :</b> To assess the effectiveness of a targeted, multiple intervention falls prevention programme in reducing falls and injuries related to falls in a subacute hospital.<br /><br /><b>Design : </b>Randomised controlled trial of a targeted multiple intervention programme implemented in addition to usual carecompared with usual care alone.<br /><br /><b>Setting :</b>Three subacute wards in a metropolitan hospital specialising in rehabilitation and care of elderly patients.<br /><br /><b>Participants : </b>626 men and women aged 38 to 99 years (average 80 years) were recruited from consecutive admissions to subacute hospital wards.<br /><br /><b>Intervention :</b> Falls risk alert card with information brochure, exercise programme, education programme, and hip protectors.<br /><b><br />Main outcome measures :</b> Incidence rate of falls, injuries related to falls, and proportion of participants who experienced one or more falls during their stay in hospital.<br /><b><br />Results : </b>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).<br /><br /><b>Conclusions :</b> A targeted multiple intervention falls prevention programme reduces the incidence of falls in the subacute hospital setting.<br />