Adherence to a multifactorial fall prevention program following paramedic care: Predictors and impact on falls and health service use. Results from an RCT a priori subgroup analysis

摘要

Objective To identify predictors and impact of adherence to a multifactorial fall‐prevention program on falls and health service utilisation. Methods Randomised controlled trial with a priori subgroup analysis within intervention group according to adherence. Participants were community dwelling, (≥65?years), not transported to hospital following fall‐related paramedic care. The Attitudes to Falls‐Related Interventions Scale ( AFRIS ) was completed at baseline, adherence levels were measured (three‐point scale) at six months, and falls and health service utilisation were recorded for 12?months. Multivariate logistic regression and area under the curve were calculated with 95% confidence interval ( CI ). Results Attitudes to Falls‐Related Interventions Scale scores ( n = 85) were independent of baseline characteristics. At six months, 39 (46%) participants reported full adherence. Independent predictors of adherence were positive AFRIS ( OR 4.10, 95% CI 1.48–11.39) and receiving 3+ recommendations ( OR 3.36, 95% CI 1.26–9.00). Adherers experienced fewer falls ( IRR 0.53, 95% CI 0.45–0.80) and fall‐related health service use (emergency department presentations IRR 0.37, 95% CI 0.17–0.82) compared to non‐adherers. Conclusion Older adults who adhere to recommendations benefit, regardless of fall‐risk profile.