Tailored education program using home floor plans for falls prevention in discharged older patients: A pilot randomized controlled trial

Abstract

Objective: To investigate the effect of a tailored education program using home floor plans on falls prevention in discharged older patients.

Design: A single-center, parallel, pragmatic, pilot randomized controlled trial with equal allocation to the intervention and control groups.

Setting: Discharged hospital patients were followed-up in their home settings.

Participants: All discharged orthopedic patients aged ≥65 years who experienced ≥1 fall(s) in the past year (n=60).

Interventions: Both groups received standard care (exercises) and the intervention group also received a tailored education program for falls prevention using home floor plans.

Measurements: Falls and near-falls at the participants' homes using a 1-month fall calendar during the 1-month period after discharge. The evaluators were blinded at the baseline assessment.

Results: Nine participants were withdrawn from the study, leaving 51 of 60 (85%) participants for the final analyses. No falls occurred in the intervention group (n=25) during follow-up. However, 2 participants (7.7%) fell in the control group (n=26). Near-falls were reported by 7 participants (28.0%) in the intervention group and 13 participants (50.0%) in the control group. The intervention group had 75% less near-falls compared with the control group, as assessed using a Cox proportional hazards model (hazard ratio, 0.25; 95% confidence interval, 0.09-0.75).

Conclusions: The tailored education program using home floor plans at the hospital was effective for reducing falls and near-falls among discharged orthopedic patients. Registration of clinical trials: This study was registered with the Research Ethics Committee of University Hospital Medical Information Network (UMIN) Center (000018201).

Keywords: Discharged patients; Education; Falls prevention; Home floor plan; Pilot randomized controlled trial.