Falls in older people Injury, Occupational Diseases, Poisoning Unspecified fall
Conditions
Interventions
Health technology being assessed: a protocol for the care of older people who have fallen, allowing emergency ambulance personnel to assess and refer patients to appropriate community based care. To
Sponsors
Swansea University (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Both males and females, aged 65 and over 2. Patients who have fallen and for whom a 999 call is made 3. The faller has to live within the study area
Exclusion criteria
Exclusion criteria: In order to maximise generalisability of findings to this group of frail patients with complex needs, no patients will be excluded due to other conditions or competence.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measures as of 25/07/2012: The rate of further contacts with emergency healthcare providers (999 calls, ED attendances, emergency admissions or death) - both for any cause and specifically for falls, as summarised by: 1. Proportion of patients who suffer these events 2. Interval to first event 3. Event rate Previous primary outcome measures until 25/07/2012: Patient outcome indicators at 1 and 6 months (From routinely collected data from the ambulance service and ED) - Further emergency healthcare contacts (999 call or ED attendance) for fall per recruited faller and time to first contact | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 25/07/2012: 1. Duration of inpatient episodes 2. Fractures arising from further falls 3. Self-reported further falls 4. Health-related quality of life, as measured by the SF12 5. 'Fear of falling' as measured by the Modified Falls Efficacy Scale 6. Patient satisfaction as measured by the Quality of Care Monitor 7. Change in place of residence 8. Pathway of care as measured by routine ambulance service data on of proportions conveyed to ED, referred to falls service, referred to other providers, or left at scene without further care 9. Durations of: ambulance service job cycle; episode of care; time to falls service response 10. Compliance with guidelines for ambulance service clinical documentation; and referrals; and for falls services follow up 11. Costs of care to NHS and personal social services, estimated by routine data from participating services 12. Self-reported costs incurred by patients and carers 13. Views of ambulance service paramedics, managers and partners on implementation of the intervention 14. Experience and satisfaction of patients receiving the intervention Previous secondary outcome measures until 25/07/2012: 1. Patient outcome indicators at 1 and 6 months: 1.1. Emergency hospital admission (and those that are fall related) and length of stay 1.2. Further falls: health related quality of life and self-efficacy - 'fear of falling' (Self-report questionnaire, SF-12® Health Survey, Euroqol EQ-5D, modified Falls Efficacy Scale [mFES]) 1.3. Injuries related to further falls, radiologically confirmed (from ED card); place of residence (self-report questionnaire) 1.4. Deaths (from coroners/register of deaths) 1.5. Patient satisfaction and experience (self-report questionnaire, Quality of Care Monitor, semi structured interview) 2. Processes of care: (routine ambulance service, ED data) The following data will be collected systematically throughout the trial: 2.1. Proportions at index fall | — |
Countries
United Kingdom
Outcome results
None listed