Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial
Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial
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DOI：
10.1136/bmj.322.7288.697
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发表时间：
2001-03-24
影响因子：
--
通讯作者：
Campbell, AJ
中科院分区：
文献类型：
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作者：
Robertson, MC;Devlin, N;Campbell, AJ
目的评估一名受过训练的地区护士单独为老年人制定一项以家庭为基础的运动计划的有效性，以减少老年人的福尔斯和受伤，并估计该计划的成本效益。设计随机对照试验，随访一年。在新西兰一家医院的社区卫生服务中。参与者240名年龄在75岁及以上的女性和男性。干预121名参与者接受了为期一年的干预。锻炼计划119例接受常规护理对照组;百分之九十主要观察指标为福尔斯数、福尔斯致伤数、实施该项目的费用和福尔斯致伤的住院费用。结果福尔斯减少了46（发生率比0.54，95%置信区间0.32 - 0.90）。在对照组中有5例住院是由于福尔斯摔倒造成的，而在运动组中没有。该方案的成本NZ 1803美元（磅523）（1998年的价格），每下降防止交付该方案和NZ 155美元，每下降防止医院成本避免时被considered.Conclusion家庭锻炼计划，以前被证明是成功的，当由一个物理治疗师，也是有效的减少福尔斯时，由一个训练有素的护士从家庭内提供健康服务。由于福尔斯跌倒而造成的严重伤害和住院人数也有所减少。与年轻的参与者相比，该方案在80岁及以上的参与者中具有成本效益。
Objectives To assess the effectiveness of a trained district nurse individually prescribing a home based exercise programme to reduce falls and injuries in elderly people and to estimate the cost effectiveness of the programme.Design Randomised controlled trial with one year's follow up.Setting Community health service at a New Zealand hospital.Participants 240 women and men aged 75 years and older.Intervention 121 participants received the exercise programme (exercise group) and 119 received usual care (control group); 90% (211 of 233) completed the trial.Main outcome measures Number of falls, number of injuries resulting from falls, costs of implementing the programme, and hospital costs as a result of falls.Results Falls were reduced by 46% (incidence rate ratio 0.54, 95% confidence interval 0.32 to 0.90). Five hospital admissions were due to injuries caused by falls in the control group and none in the exercise group. The programme cost $NZ1803 (pound 523) (at 1998 prices) per fall prevented for delivering the programme and $NZ155 per fall prevented when hospital costs averted were considered.Conclusion A home exercise programme, previously shown to be successful when delivered by a physiotherapist, was also effective in reducing falls when delivered by a trained nurse from within a home health service. Serious injuries and hospital admissions due to falls were also reduced. The programme was cost effective in participants aged 80 years and older compared with younger participants.