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Keeping Patients on Their Feet: How Fall Prevention Clinics Can Be More Effective.

David R Lee¹, Lauren K Matsuno², Joyce H Seo²

¹Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. drlee@mednet.ucla.edu.

Journal of General Internal Medicine

|February 27, 2026

Summary

Fall prevention programs provide recommendations, but implementation is inconsistent, leading to no significant reduction in fall-related emergency visits or hospitalizations. Improving adherence to physical therapy and bone health interventions is crucial for better outcomes.

Keywords:

bone health fall prevention interdisciplinary team physical therapy quality improvement

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Area of Science:

Geriatrics
Preventive Medicine
Public Health

Background:

Limited evidence exists on the clinical effectiveness of real-world fall prevention programs.
Understanding the gap between fall risk recommendations and clinical outcomes is essential.
This study investigates the implementation rates of recommendations from a fall prevention clinic.

Purpose of the Study:

To evaluate the implementation rates of recommendations generated by an interdisciplinary fall prevention clinic.
To assess the impact of these recommendations on fall and fracture-related emergency department visits and hospitalizations.

Main Methods:

Retrospective cohort study of 94 patients aged 63-101 years attending a fall prevention clinic (Nov 2020-Dec 2022).
Data collected included demographics, screening assessments (falls, fracture risk, vision, cognition, orthostatic hypotension), physical therapy evaluations, and recommendation implementation.
Fall and fracture-related emergency department visits and hospitalizations were compared pre- and post-clinic evaluation.

Main Results:

High rates of positive screenings for falls (81%), fracture risk (67%), and vision impairment (43%).
Recommendation implementation was highest for home/outpatient physical therapy (58%/46%) and bone health (50%).
Referrals to podiatry (30%), clinical pharmacy (29%), osteoporosis clinic (23%), and memory clinic (12%) had lower implementation rates.
No statistically significant differences were found in fall- or fracture-related emergency department visits or hospitalizations post-clinic.

Conclusions:

The consultative fall prevention clinic generated actionable recommendations, but implementation was sub-optimal.
Key areas for process improvement include enhancing adherence to high-impact recommendations.
Improving implementation of physical therapy and bone health interventions is critical for fall prevention efficacy.