| |
Centre for Policy on Ageing | |
 | |
|
Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment
— systematic review and meta-analyses | | Author(s) | David Oliver, James B Connelly, Christina R Victor |
| Journal title | British Medical Journal, vol 334 no 7584, 13 January 2007 |
| Pages | pp 82-85 |
| Source | http://www.bmj.com |
| Keywords | Falls ; Fractures ; Preventative medicine ; Hospital services ; Nursing homes ; Mental disorder ; Clinical surveys ; Literature reviews. |
| Annotation | Evidence for strategies to prevent falls and fractures in care home residents and hospital inpatients was evaluated, and the effect of dementia and cognitive impairment investigated. 1027 references, including 115 systematic reviews, expert views or guidelines were identified on searches of Medline, CINAHL, Embase, Psychinfo, Cochrane Database, and Clinical Trails Register, also hand searching of references from reviews and guidelines until January 2005. Of 92 full papers inspected, 43 were included. Meta analysis for multifaceted interventions in hospital (13 studies) showed a rate ratio of 0.82 for falls, but no significant effect on the number of fallers or fractures. For hip protectors in care homes (11 studies), the rate ratio for hip fractures was 0.67 (0.46 to 0.98), but there was no significant effect on falls and not enough studies on fallers. For all other interventions (multifaceted interventions in care homes, removal of physical restraint, fall alarm devices, exercise, changes in the physical environment, use of calcium or vitamin D, and medication review in hospital), meta analysis was either unsuitable because of insufficient studies, or showed no significant effect on falls, fallers, or fractures, despite strongly positive results in some individual studies. Meta regression showed no significant association between effect size and prevalence of dementia or cognitive impairment. There is some evidence that multifaceted interventions in hospital reduce the number of falls and that use of hip protectors in care homes prevents hip fractures. There is insufficient evidence, though, for the effectiveness of other single interventions in hospitals or care homes or multifaceted interventions in care homes. (RH) |
| Accession Number | CPA-070125205 A |
| Classmark | OLF: CUF: LK2: LD: LHB: E: 3G: 64A * |
Data © Centre for Policy on Ageing |
|
| ...from the Ageinfo database published by Centre for Policy on Ageing. |
| |
|