A multidomain decision support tool to prevent falls in older people: the FinCH cluster RCT

Area of Science:

• Gerontology
• Public Health
• Health Services Research

Background:

• Falls are a common, costly, and challenging issue in care home settings.
• Effective prevention strategies are crucial for resident well-being and healthcare system efficiency.

Purpose of the Study:

• To evaluate the clinical effectiveness of the Guide to Action for falls prevention in Care Homes (GtACH) programme.
• To assess the cost-effectiveness of the GtACH programme for preventing falls among care home residents.

Main Methods:

• A multicentre, cluster, randomised controlled trial comparing the GtACH programme with usual care.
• The GtACH programme involved staff training, a decision support tool, and implementation of falls prevention actions.
• Primary outcome was the rate of falls per resident between 91 and 180 days post-randomisation; economic evaluations were embedded.

Main Results:

• The GtACH programme resulted in a significant reduction in falls rates (incidence rate ratio 0.57, p < 0.01).
• No significant differences were observed in activity levels or dependency between the GtACH and control groups.
• The incremental cost per fall averted was £190.62, indicating cost-effectiveness.

Conclusions:

• The GtACH programme effectively reduces falls in care homes without negatively impacting residents' activity or dependency.
• The programme is a cost-effective intervention within the NHS at current thresholds.
• Future implementation should focus on scalability and sustainability of the GtACH programme.