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Can health visitors prevent fractures in elderly people?
N J Vetter1, P A Lewis, D Ford
1University of Wales College of Medicine, Cardiff.
Objectives:
To assess whether intervention by a health visitor could reduce the number of fractures, over a four year period, in those aged 70 and over.
Design:
Randomised, controlled trial; randomisation by household.
Setting:
General practice in a market town.
Subjects:
Of 863 patients aged 70 and over on the practice records, 674 were traced and successfully interviewed; 350 were assigned to the intervention group, 324 as controls.
Intervention:
The people in the intervention group were allocated to the care of a health visitor. The approach was four pronged: assessment and correction of nutritional deficiencies, including reducing smoking and alcohol intake; assessment and referral of medical conditions such as heart block or inappropriate medication; assessment and correction of environmental hazards in the home such as poor lighting; assessment and improvement of fitness--for example, exercise classes for the moderately fit. The intervention continued for four years.
Main Outcome Measure:
Fracture rate over four years.
Results:
The incidence of fractures was 5% (16/350) in the intervention group and 4% (14/324) in the control group (difference not significant).
Conclusions:
A health visitor visiting a group of people aged 70 and over and using simple preventive measures had no effect on the incidence of fractures.