Īlthough methodologically rigorous systematic reviews have been conducted on falls prevention, none have ranked all of the available interventions using a network meta-analysis approach. Falls leading to hip fracture are the most costly at $40,000 CAD per senior. One in 5 people who suffer a hip fracture will die during the first year, and less than 1/3 will regain their pre-fracture level of physical function. įalls leading to hip fractures have the most devastating prognosis. For falls that result in hospitalization, the average cost is $30,000 CAD per senior. Falls are the underlying cause of 10-15% of all emergency room visits for seniors and account for 40% of all deaths due to injury. Of all community dwelling individuals who fall, 12% to 42% will have a falls-related injury, with up to 20% requiring medical attention and 10% resulting in fracture secondary to osteoporosis. įalling can lead to anxiety, depression, social isolation, and immobility. Seniors who fall are two to three times more likely to fall again within one year and the incidence of falls will only increase in the future, due to the growing proportion of older people. Each year, approximately 30% of community-dwelling individuals aged 65 and older and 50% of community dwellers aged 85 and older fall. Systematic review registrationįalls (most commonly defined as “an unintentional/inadvertent/involuntary or accidental coming to rest on a lower level”) are a significant burden to society. Our results will be used to optimize falls prevention strategies, and our goal is to ultimately improve the health of seniors internationally. We will identify the most effective interventions and combinations of interventions that prevent falls in older people. If appropriate, a network meta-analysis will be conducted, which will allow the comparison of interventions that have not been compared in head-to-head RCTs, as well as the effectiveness of interventions. Our results will be synthesized descriptively and a random effects meta-analysis will be conducted if the studies are deemed methodologically, clinically, and statistically (e.g., I 2<60%) similar. A similar process will be used for data abstraction and quality appraisal with the Cochrane risk of bias tool. Conflicts will be resolved through team discussion. We will calibrate our eligibility criteria amongst the team and two independent team members will screen the literature search results in duplicate.
Secondary outcomes include falls rate, number of fallers, number of emergency room visits due to falls, number of physician visits due to falls, number of fractures, costs, and number of intervention-related harms (e.g., muscle soreness related to exercise). The primary outcomes are number of injurious falls and number of hospitalizations due to falls.
#WHAT IS COMPREHENSIVE META ANALYSIS FOR HEALTHCARE TRIAL#
We will search for published (e.g., MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Ageline) and unpublished (e.g., trial registries, dissertations) randomised clinical trials (RCTs) in all languages examining interventions to prevent falls compared to usual care or other falls prevention interventions among adults aged ≥65 years from all settings (e.g., community, acute care, long-term care, and rehabilitation). Our objective is to identify the most effective interventions and combinations of interventions that prevent falls though a systematic review and meta-analysis, including a network meta-analysis.
Although numerous trials of falls prevention interventions have been completed, there is extensive variation in their intervention components and clinical context, such that the key elements of an effective falls prevention program remain unclear to patients, clinicians, and policy-makers. Falls are a leading cause of morbidity and mortality in older adults.
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