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Evaluating a Paramedic-Led Fall-Referral Program in Nova Scotia: a Mixed-Methods Study.

Luke Duignan1, Izabelle Opra2, Alix Je Carter3

  • 1Department of Medicine, Dalhousie University.

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|November 27, 2025
PubMed
Summary
This summary is machine-generated.

Paramedic referrals to fall prevention programs did not reduce repeat falls. Key barriers included patient reluctance, lack of education, and poor feedback systems for these crucial fall prevention initiatives.

Keywords:
community-based interventionfall preventiongeriatric careparamedicinepre-hospital care

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Area of Science:

  • Gerontology
  • Public Health
  • Emergency Medical Services

Background:

  • Falls in older adults represent a significant global health challenge, contributing to high morbidity, mortality, and healthcare expenses.
  • Paramedics are uniquely positioned to manage post-fall situations and potentially intervene in fall prevention.
  • Understanding referral patterns and their effectiveness is crucial for optimizing care for elderly fallers.

Purpose of the Study:

  • To quantify the frequency of paramedic referrals to fall prevention programs.
  • To identify factors influencing paramedics' referral decisions.
  • To compare fall-related outcomes between older adults who received a referral and those who did not.

Main Methods:

  • A mixed-methods approach was employed, evaluating a paramedic fall-referral program in Nova Scotia for older adults with non-transport dispositions.
  • Patient data and outcomes were analyzed using a matched cohort design (1:2 ratio).
  • Paramedic perspectives on the referral program were explored using The Theory of Planned Behavior.

Main Results:

  • Between 2014 and 2019, 289 referrals were made.
  • A matched cohort analysis revealed no significant difference in the mean number of fall-related 911 calls within 12 months between referred and non-referred groups (0.31 vs. 0.30 calls).
  • Paramedics cited patient reluctance, insufficient education, lack of feedback, and program systematization issues as major referral barriers.

Conclusions:

  • The paramedic fall-prevention referral program in Nova Scotia demonstrated low referral rates and did not significantly reduce recurrent fall-related emergency calls.
  • Addressing barriers such as patient engagement, paramedic education, and feedback mechanisms is essential for improving the effectiveness of such programs.
  • Paramedics can play an enhanced role in preventing age-related health issues like falls through improved referral systems.