Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series.
Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series.
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DOI：
10.1371/journal.pone.0161579
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Cherubini A
中科院分区：
文献类型：
--
作者：
Rimland JM;Abraha I;Dell'Aquila G;Cruz-Jentoft A;Soiza R;Gudmusson A;Petrovic M;O'Mahony D;Todd C;Cherubini A
跌倒是老年人的常见事件，会导致相当大的发病率和死亡率。非药物干预是预防跌倒的重要方法。有大量的非药物干预措施的系统评价，其证据需要综合，以促进循证的临床决策。系统地审查评价社区、护理机构和医院预防老年人跌倒的非药物干预措施的综述和荟萃分析。我们检索了2009年1月至2015年3月的电子数据库Pubmed、Cochrane系统评价数据库、EMBASE、CINAHL、SqucINFO、Pedro和Trip，寻找系统评价，其中包括至少一项比较研究，评估任何非药物干预措施，以预防老年人跌倒。使用AMSTAR对审查的质量进行评估，并使用亵渎分类法组织干预。确定了59项系统性评价，其中包括预防老年人跌倒的单因素、多因素和多因素非药物干预。最常见的亵渎定义的干预措施是单独或与其他干预措施相结合的演习，其次是环境/辅助技术干预措施，包括环境修改、辅助和保护辅助设备、工作人员教育和视力评估/矫正。知识是作为患者教育的第三类干预措施。运动和多因素干预是减少老年人跌倒的最有效的治疗方法，尽管并不是所有类型的运动在所有受试者和所有环境中都同样有效。有效的锻炼计划结合了平衡和力量训练。AMSTAR评分越高的综述越有可能包含更多的初步研究，需要更新并进行荟萃分析。本文综述了在不同环境下预防老年人跌倒的非药物干预措施，旨在通过提供一个全面的研究结果视角，为临床医生和其他医护人员提供临床决策支持。
Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making. To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals. We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions. Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis. The aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.