Journal article
Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health-related quality of life
Journal of the American Geriatrics Society (JAGS), Vol.70(11), pp.3221-3229
11/01/2022
DOI: 10.1111/jgs.17964
PMCID: PMC9669115
PMID: 35932279
Abstract
Background Falls are common in older adults and can lead to severe injuries. The Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) trial cluster-randomized 86 primary care practices across 10 health systems to a multifactorial intervention to prevent fall injuries, delivered by registered nurses trained as falls care managers, or enhanced usual care. STRIDE enrolled 5451 community-dwelling older adults age >= 70 at increased fall injury risk. Methods We assessed fall-related outcomes via telephone interviews of participants (or proxies) every 4 months. At baseline, 12 and 24 months, we assessed health-related quality of life (HRQOL) using the EQ-5D-5L and EQ-VAS. We used Poisson models to assess intervention effects on falls, fall-related fractures, fall injuries leading to hospital admission, and fall injuries leading to medical attention. We used hierarchical longitudinal linear models to assess HRQOL. Results For recurrent event models, intervention versus control incidence rate ratios were 0.97 (95% confidence interval [CI], 0.93-1.00; p = 0.048) for falls, 0.93 (95% CI, 0.80-1.08; p = 0.337) for self-reported fractures, 0.89 (95% CI, 0.73-1.07; p = 0.205) for adjudicated fractures, 0.91 (95% CI, 0.77-1.07; p = 0.263) for falls leading to hospital admission, and 0.97 (95% CI, 0.89-1.06; p = 0.477) for falls leading to medical attention. Similar effect sizes (non-significant) were obtained for dichotomous outcomes (e.g., participants with >= 1 events). The difference in least square mean change over time in EQ-5D-5L (intervention minus control) was 0.009 (95% CI, -0.002 to 0.019; p = 0.106) at 12 months and 0.005 (95% CI, -0.006 to 0.015; p = 0.384) at 24 months. Conclusions Across a standard set of outcomes typically reported in fall prevention studies, we observed modest improvements, one of which was statistically significant. Future work should focus on patient-, practice-, and organization-level operational strategies to increase the real-world effectiveness of interventions, and improving the ability to detect small but potentially meaningful clinical effects. identifier: NCT02475850.
Details
- Title: Subtitle
- Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health-related quality of life
- Creators
- David A. Ganz - University of California, Los AngelesAnita H. Yuan - University of California, Los AngelesErich J. Greene - Yale UniversityNancy K. Latham - Brigham and Women's HospitalKaty Araujo - Yale UniversityAlbert L. Siu - Icahn School of Medicine at Mount SinaiJay Magaziner - University of Maryland, BaltimoreJerry H. Gurwitz - University of Massachusetts Chan Medical SchoolAlbert W. Wu - Johns Hopkins UniversityNeil B. Alexander - University of MichiganRobert B. Wallace - University of IowaSusan L. Greenspan - University of PittsburghJeremy Rich - HealthCare Partners Institute for Applied Research and EducationElena Volpi - The University of Texas Medical Branch at GalvestonStephen C. Waring - Essentia HealthPatricia C. Dykes - Brigham and Women's HospitalFred Ko - Icahn School of Medicine at Mount SinaiNeil M. Resnick - University of PittsburghSiobhan K. McMahon - University of MinnesotaShehzad Basaria - Brigham and Women's HospitalRixin Wang - Yale Cancer CenterCharles Lu - Yale Cancer CenterDenise Esserman - Yale UniversityJames Dziura - Yale UniversityMichael E. Miller - Wake Forest UniversityThomas G. Travison - Brigham and Women's HospitalPeter Peduzzi - Yale UniversityShalender Bhasin - Brigham and Women's HospitalDavid B. Reuben - University of California, Los AngelesThomas M. Gill - Yale University
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.70(11), pp.3221-3229
- DOI
- 10.1111/jgs.17964
- PMID
- 35932279
- PMCID
- PMC9669115
- NLM abbreviation
- J Am Geriatr Soc
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Publisher
- Wiley
- Number of pages
- 9
- Grant note
- 5U01AG048270; KL2TR000113; P30AG031679; P30AG021342; P30AG024824; P30AG024827; P30AG024832; UL1TR000114; UL1TR000142 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Patient Centered Outcomes Research Institute; Patient-Centered Outcomes Research Institute - PCORI
- Language
- English
- Date published
- 11/01/2022
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984364406602771
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