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Implementing Falls Prevention in Primary Care: Barriers and Facilitators.

Wytske M A Meekes1,2, Chantal J Leemrijse2, Joke C Korevaar2

  • 1Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.

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Summary

Primary care providers face barriers and facilitators in falls prevention. Addressing collaboration, resources, reimbursement, and patient factors can improve implementation for older adults.

Keywords:
barriers and facilitatorsfalls preventionfrail older peopleimplementationprimary care

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Area of Science:

  • Gerontology
  • Primary Care Medicine
  • Public Health

Background:

  • Falls are a significant threat to the quality of life for independently living older adults.
  • Limited research exists on primary care providers' experiences with falls prevention implementation and interventions.
  • Understanding barriers and facilitators is crucial for effective falls prevention strategies in real-world settings.

Purpose of the Study:

  • To identify barriers and facilitators encountered by primary care providers (GPs, practice nurses, community nurses) when implementing a falls risk assessment strategy.
  • To identify barriers and facilitators in providing evidence-based falls prevention interventions to frail, independently living older people.
  • To inform the development of more successful implementation strategies for falls prevention in primary care.

Main Methods:

  • A researcher's journal documented informal conversations during the implementation of a falls risk assessment strategy.
  • Two online focus groups were conducted with GPs, practice nurses, community nurses, physiotherapists, and exercise therapists post-implementation.
  • Thematic analysis was used to analyze qualitative data from the journal and focus groups.

Main Results:

  • GPs and nurses recognized falls prevention as meaningful, part of their role, and felt they had adequate knowledge and skills.
  • Key facilitators for implementation included collaboration, existing care programs, resources, reimbursement, and patient motivation/awareness/health.
  • Physiotherapists and exercise therapists highlighted collaboration, referrals, reimbursement, intervention design, and patient-specific factors (motivation, expectations, self-confidence, health) as critical.

Conclusions:

  • Barriers and facilitators span care providers, context, patients, and the intervention strategy itself.
  • Future implementation strategies should prioritize enhanced collaboration, adequate reimbursement, resource availability, and addressing patient motivation and health issues.
  • Structural application of falls prevention can be improved, thereby reducing a major threat to older adults' quality of life.