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Open Access Highly Accessed Research article

Falls Assessment Clinical Trial (FACT): design, interventions, recruitment strategies and participant characteristics

C Raina Elley1*, M Clare Robertson2, Ngaire M Kerse1, Sue Garrett3, Eileen McKinlay3, Beverley Lawton3, Helen Moriarty3 and A John Campbell2

Author Affiliations

1 Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand

2 Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand

3 Department of Primary Healthcare and General Practice, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand

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BMC Public Health 2007, 7:185  doi:10.1186/1471-2458-7-185

Published: 29 July 2007

Abstract

Background

Guidelines recommend multifactorial intervention programmes to prevent falls in older adults but there are few randomised controlled trials in a real life health care setting. We describe the rationale, intervention, study design, recruitment strategies and baseline characteristics of participants in a randomised controlled trial of a multifactorial falls prevention programme in primary health care.

Methods

Participants are patients from 19 primary care practices in Hutt Valley, New Zealand aged 75 years and over who have fallen in the past year and live independently. Two recruitment strategies were used – waiting room screening and practice mail-out. Intervention participants receive a community based nurse assessment of falls and fracture risk factors, home hazards, referral to appropriate community interventions, and strength and balance exercise programme. Control participants receive usual care and social visits. Outcome measures include number of falls and injuries over 12 months, balance, strength, falls efficacy, activities of daily living, quality of life, and physical activity levels.

Results

312 participants were recruited (69% women). Of those who had fallen, 58% of people screened in the practice waiting rooms and 40% when screened by practice letter were willing to participate. Characteristics of participants recruited using the two methods are similar (p > 0.05). Mean age of all participants was 81 years (SD 5). On average participants have 7 medical conditions, take 5.5 medications (29% on psychotropics) with a median of 2 falls (interquartile range 1, 3) in the previous year.

Conclusion

The two recruitment strategies and the community based intervention delivery were feasible and successful, identifying a high risk group with multiple falls. Recruitment in the waiting room gave higher response rates but was less efficient than practice mail-out. Testing the effectiveness of an evidence based intervention in a 'real life' setting is important.

Trial registration

Australian Clinical Trials Register ID 12605000054617.