Are older adults receiving evidence-based advice to prevent falls post-discharge from hospital?

Abstract

Background:

Older adults experience a high rate of falls when they transition to community-living following discharge from hospital.

Objectives:

To describe the proportion of older adults who could recall having discussed falls and falls prevention strategies with a health professional within 6 months following discharge from hospital. To describe the recalled content of these discussions and the strategies recommended and/or undertaken to prevent falls.

Methods:

Prospective cohort study of 155 older adults surveyed prior to discharge from hospital, of whom 123 were followed up at month 3 and/or month 6 in the community post-discharge. Participants were recruited from three Australian hospitals. Questionnaires captured predictive factors that may predispose to a fall and data related to the objectives being examined.

Results:

Of the 123 participants who had at least one follow-up, 54 reported discussing falls with a health professional (49 discussed falls with their general practitioners). Of the 54 participants who recalled having a discussion, 33 commented that they were asked whether they had fallen over. Only six discussed interventions to prevent falls. However, 44 stated that they attempted a total of 53 strategies to prevent falls post-discharge. Of these strategies, 40 had an absence of evidence of effectiveness, 11 had evidence of effectiveness, while two had either evidence of no benefit/harm or evidence of harm for the prevention of falls. In all, 53 participants reported falling post-discharge, but 42% of them did not recall discussing falls with their health professional.

Conclusion:

There is considerable scope for health professionals, especially general practitioners, to increase the frequency with which they discuss falls and evidence-based interventions to prevent falls in this population.