Fall prevention interventions for older community-dwelling adults: systematic reviews on benefits, harms, and patient values and preferences

• Published in: Systematic reviews 2021-01, Vol.10 (1), p.18-18, Article 18
• Main Authors: Pillay, Jennifer, Riva, John J, Tessier, Laure A, Colquhoun, Heather, Lang, Eddy, Moore, Ainsley E, Thombs, Brett D, Wilson, Brenda J, Tzenov, Amanda, Donnelly, Catherine, Émond, Marcel, Holroyd-Leduc, Jayna, Milligan, Jamie, Keto-Lambert, Diana, Rahman, Sholeh, Vandermeer, Ben, Tricco, Andrea C, Straus, Sharon E, Thomas, Sonia M, Mitchelmore, Bradley R, Rolland-Harris, Elizabeth, Hartling, Lisa
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Aged; Balance; Canada; CINeMA; Cross-Sectional Studies; Emergency medical care; Europe; Evidence-based medicine; Fall prevention; Falls; GRADE; Guideline; Health care; Health risk assessment; Humans; Independent Living; Injuries; Injury prevention; Intervention; Older people; Patient values and preferences; Patients; Primary care; Protocol; Quality of Life; Risk factors; Systematic review; Systematic Reviews as Topic; Taxonomy
• ISSN: 2046-4053; 2046-4053
• DOI: 10.1186/s13643-020-01572-7

An estimated 20-30% of community-dwelling Canadian adults aged 65 years or older experience one or more falls each year. Fall-related injuries are a leading cause of hospitalization and can lead to functional independence. Many fall prevention interventions, often based on modifiable risk factors, have been studied. Apart from the magnitude of the benefits and harms from different interventions, the preferences of older adults for different interventions as well as the relative importance they place on the different potential outcomes may influence recommendations by guideline panels. These reviews on benefits and harms of interventions, and on patient values and preferences, will inform the Canadian Task Force on Preventive Health Care to develop recommendations on fall prevention for primary care providers. To review the benefits and harms of fall prevention interventions, we will update a previous systematic review of randomized controlled trials with adaptations to modify the classification of interventions and narrow the scope to community-dwelling older adults and primary-care relevant interventions. Four databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Ageline), reference lists, trial registries, and relevant websites will be searched, using limits for randomized trials and date (2016 onwards). We will classify interventions according to the Prevention of Falls Network Europe (ProFANE) Group's taxonomy. Outcomes include fallers, falls, injurious falls, fractures, hip fractures, institutionalization, health-related quality of life, functional status, and intervention-related adverse effects. For studies not included in the previous review, screening, study selection, data extraction on outcomes, and risk of bias assessments will be independently undertaken by two reviewers with consensus used for final decisions. Where quantitative analysis is suitable, network or pairwise meta-analysis will be conducted using a frequentist approach in Stata. Assessment of the transitivity and coherence of the network meta-analyses will be undertaken. For the reviews on patient preferences and outcome valuation (relative importance of outcomes), we will perform de novo reviews with searches in three databases (MEDLINE, PsycInfo, and CINAHL) and reference lists for cross-sectional, longitudinal quantitative, or qualitative studies published from 2000. Selection, data extraction, and risk of bias assessments suitable for each study design wil