Evidence-based clinical practice in falls prevention: a randomised controlled trial of a falls prevention service.
Evidence-based clinical practice in falls prevention: a randomised controlled trial of a falls prevention service.
复制标题
跌倒预防的循证临床实践：跌倒预防服务的随机对照试验。
作者：
C. Whitehead;R. Wundke;M. Crotty;P. Finucane
旨在
循证指南推荐了一系列治疗福尔斯和预防伤害的方法。我们进行了一项福尔斯预防服务的随机试验，以筛查福尔斯风险因素，并向全科医生推荐一种预防福尔斯的有证据的基础处方。
方法
所有在弗林德斯医疗中心急诊科跌倒超过22周的患者都被考虑参加这项研究。我们排除了患有痴呆症的患者，居住在高度护理或转移到其他医院和我们的集水区以外的患者。在那些同意的患者中，我们将患者随机分为常规护理组和干预组，干预组包括福尔斯风险评估和书面循证处方传真给他们的GP以采取行动。患者随访6个月，并监测其对建议的接受率和跌倒率。
结果
450例患者出现跌倒相关就诊，其中261例患者有资格入选试验。在这261例患者中，140例患者同意并入组试验。在六个月内，干预组的患者更有可能接受预防性建议（OR=12.3; 95%CI=4.2-35.9）。我们无法显示福尔斯跌倒的减少（OR= 1.7; 95%CI=0.7-4.4）。
结论
以患者为中心的循证方法在增加福尔斯预防建议的吸收方面是可行和有效的。长期遵守咨询意见需要进一步探讨。
AIMS
Evidence-based guidelines recommend a range of treatments for falls and injury prevention. We undertook a randomised trial of a falls prevention service to screen for falls risk factors and recommend to GPs an evidenced base prescription for falls prevention.
METHODS
All patients who presented with a fall to the Emergency Department at Flinders Medical Centre over a 22-week period were considered for the study. We excluded patients with dementia, resident in high care or those transferred to other hospitals and outside our catchment area. Of those who consented, we randomised patients between usual care or to an intervention consisting of a falls risk assessment and writing of an evidence-based prescription faxed to their GP for action. Patients were followed for six months and uptake of advice and fall rates were monitored.
RESULTS
Four hundred and fifty patients presented with a fall-related attendance and of these 261 patients were eligible for inclusion in the trial. Of these 261 patients, 140 consented and were enrolled in the trial. Over the six months patients in the intervention group were more likely to uptake preventative advice (OR=12.3; 95%CI=4.2-35.9). We were unable to show a reduction in falls (OR= 1.7; 95%CI=0.7-4.4).
CONCLUSIONS
A patient centered evidence-based approach is feasible and effective in increasing uptake of falls prevention advice. Long term compliance with advice needs further exploration.
影响因子：
158.5
作者：
DawsonHughes, B;Harris, SS;Dallal, GE
通讯作者：
Dallal, GE
DOI：
10.1093/geronj/45.6.p239
发表时间：
1990-11-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
TINETTI, ME;RICHMAN, D;POWELL, L
通讯作者：
POWELL, L