Frail independently living older people, diseases not specified
Conditions
Interventions
A systematic and targeted fall risk screening approach will be implemented at GP practices. The systematic fall risk screening approach used in this study consists of two parts. In the first part, GP
WHO, 2008
Nederlandse Vereniging voor Klinische Geriatrie, 2017) and completed after a discussion within the research group that includes a GP specialized in elderly care.
3. An overview of all physio- and exer
Sponsors
Tilburg University
Eligibility
Inclusion criteria
Inclusion criteria: Patients from GPs, practice nurses or home care providers who are frail and have an increased fall risk.
Exclusion criteria
Exclusion criteria: 1. Not classified as frail according to the TFI, TRAZAG Startdocument, own expertise or another frailty screening instrument, 2. Currently undertaking fall prevention interventions from a physio- or exercise therapist, 3. Moderate to severe communication restrictions or impairments, 4. According to their GP not healthy enough to participate in this study (e.g. life expectancy 2< year), or 5. Having a ZorgZwaartePakket (Care Intensity Package) of 5 or higher, indicating not living independent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The objective of this study is to evaluate if the implementation of a systematic and targeted screening of fall risk among independently living frail older people in primary care will result in more referrals to existing evidence-based fall prevention interventions. This will be evaluated with help of the RE-AIM model of Glasgow et al (1999): Reach, Effectiveness, Adoption, Implementation and Maintenance. Evaluation will take place at the level of the primary care provider (implementation index) in Part 1 and the level of the patient (patient-related outcome measures) in Part 2 of this study. In Part 1 of this research, the reach of the implementation strategy at the level of the primary care provider will be evaluated with the following outcome measures: 1.The percentage of vulnerable elderly screened for fall prevention care; 2.The percentage of screened vulnerable elderly eligible for a fall prevention program; 3.The percentage of eligible elderly for a fall prevention program that agreed with a referral to a fall prevention program 4.The percentage of vulnerable elderly that actually start the program 5.The percentage of vulnerable elderly that complete the program. In Part 2 of this research, the effectiveness of the fall prevention implementation strategy on patient level will be assessed. In this part, based on the patient’s risk profile, patients are offered fall prevention interventions by their GP, practice nurse or home care provider like referral to an exercise program, treatment of urine incontinence, or perhaps an adjustment of medication. The group of patients who receive an exercise program are called group 1. The group of patients who are treated by their GP in example for urine incontinence or adjustment of medication, are called group 2. Patients from both groups can receive several fall prevention interventions, yet group 1 patients always receive an exercise program and group 2 patients do not. (see Figure 1. Overview procedures fall prev | — |
Contacts
Public ContactWytske Meekes
Tranzo, Tilburg University
Outcome results
None listed