Fall prevention education among older hospital inpatients: a systematic review

Hospitalized older adults are at high risk of falls. Although fall prevention education is recommended in hospital settings, the efficacy of different education programs remains inconsistent. This study aimed to systematically review the effectiveness of fall prevention education interventions among older inpatients.

We conducted a systematic review of randomized or trial-linked evaluations of fall prevention education programs for inpatients aged ≥60 years. A comprehensive search was performed across PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases from inception to January 7, 2026. Risk of bias was assessed for all included evaluations. Intervention characteristics, including format, content, duration, providers, and theoretical frameworks, were extracted and analyzed.

Twelve reports describing 11 trial-based evaluations were included, with risk of bias ranging from low to high. Most reports described session-level or initial education contact of ≤1 h, whereas six reports incorporated protocol-specified repeated education, reinforcement, or post-education contact. Interventions varied considerably in format, content, duration, and providers, including physiotherapists, an occupational therapist, nurses or nurse investigators, a trained MSc sport science student, allied health assistants, and investigators with unspecified professional background. Five evaluations reported reductions in at least one fall-related measure, and one evaluation reported benefit only among cognitively intact patients. Six evaluations reported favorable education-related outcomes where measured. Behavior-related outcomes were mixed: three reports showed improvements in selected risk-reducing behaviors, whereas two reports found no significant behavior-related between-group differences. The 11 assessed programs used several theoretical or design approaches and demonstrated high educational-design quality, with scores ranging from 15 to 17 on a 17-point scale.

Fall prevention education may help reduce falls and improve related outcomes among older inpatients; however, substantial heterogeneity in study design, intervention characteristics, and outcome measures limits generalizability. The use of explicit theoretical or design approaches may support more structured educational intervention design, but further comparative evaluation is needed to determine which delivery models and components are most effective.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251238711.