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Electronic Strategies for Tailored Exercise to Prevent Falls: Evaluating Implementation in Primary Care
Jenna Reisler1, Patricia Dykes2, Nancy K Latham3
1The University of Texas Medical Branch at Galveston, Texas, United States, Galveston.
Applied Clinical Informatics
|June 23, 2026
Summary
Clinical decision support (CDS) successfully identified older adults at high risk for falls and connected them to exercise programs. However, clinician adoption varied, and patient sex influenced uptake, suggesting a need for targeted implementation strategies.
Area of Science:
- Gerontology
- Public Health
- Health Informatics
Background:
- Falls represent a significant public health concern, being the primary cause of injury and mortality in older adults.
- Clinical decision support (CDS) systems offer a potential avenue to enhance clinician referrals and patient engagement in fall prevention programs.
Purpose of the Study:
- To evaluate the implementation of a CDS intervention designed to link high-risk older adults with gait and balance exercises.
- To identify patient and clinician factors associated with the successful uptake of this fall prevention intervention.
Main Methods:
- The study employed the RE-AIM framework to assess implementation over one year in an academic health system.
- Eligible participants included community-dwelling adults aged 65 and older undergoing in-person visits.
- Key components included standardized fall risk screening, CDS alerts, electronic order sets for exercise, and hierarchical logistic regression for factor analysis.
Main Results:
- The CDS alert successfully reached 92.6% of eligible patients, with 30.5% connected to exercise.
- Male sex was associated with lower odds of connection, while a history of recent falls or falls with injury increased odds.
- Significant variation in adoption was observed among clinicians (ICC ≈ 30%), with no differences noted by patient demographics or clinician qualifications.
Conclusions:
- CDS tools are effective in identifying high-risk older adults and facilitating referrals for fall prevention exercises.
- Modest adoption rates and clinician variability highlight the need for targeted strategies to improve implementation.
- Addressing patient-specific factors, such as sex, and fall history is crucial for optimizing intervention uptake.
