Longitudinal Outcome in a Veterans Geriatric Multifactorial Falls Assessment Clinic

NCT ID: NCT02356211

Last Updated: 2020-03-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 109 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2008-08-31
• Study Completion Date: 2017-01-31

Brief Summary

Objective To reduce subsequent falls following Multifactorial Falls Assessment Design: Prospective Case Control

Population: Frail elderly Veteran outpatient population referred for falls assessment

Methods: Prospective controlled trial of Geriatric Multifactorial Falls Assessment Clinic patients followed for 1 year and outcomes compared to Acute Geriatric Evaluation and Management (GEM) Inpatient Unit discharge control group.

Detailed Description

We designed a prospective controlled trial to compare the effectiveness of outpatient falls assessment and treatment for community-dwelling frail elderly patients with history of falls referred to an active management Geriatric Multifactorial Falls Assessment Clinic with a control group of patients discharged from an Acute Geriatric Evaluation and Management (GEM) Inpatient Unit during the same time period, but who were not specifically referred for falls assessment. We hypothesized that a population of frail elderly referred by their primary care physicians and who reported for evaluation to a Geriatric Multifactorial Falls Assessment Clinic would show a reduction in falls compared to controls, when provided a time-limited consult evaluation with active follow-up for 1 year.

Conditions

Aging

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Treatment

Geriatric Multifactorial Falls Assessment Clinic

Group Type: EXPERIMENTAL

Multifactorial Falls Assessment

Intervention Type: OTHER

The Geriatric Multifactorial Falls Assessment Clinic is a component of GERIATRIC-PACT, a frail-elderly primary care patient-centered medical home with care provided by an inter-professional teamlet consisting of a geriatrician, geriatric nurse practitioner, clinical pharmacist, licensed practical nurse, nurse care manager, social worker, and dietitian. GERIATRIC-PACT operates with increased ancillary support compared to Primary Care PACT. Falls assessment patients were referred by primary care providers and were evaluated and treated by the GERIATRIC-PACT teamlet, including ordering of tests and medication adjustment, with an average of two visits and active follow-up for one year.

Control

Geriatric Evaluation and Management Service (GEM)

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Multifactorial Falls Assessment

The Geriatric Multifactorial Falls Assessment Clinic is a component of GERIATRIC-PACT, a frail-elderly primary care patient-centered medical home with care provided by an inter-professional teamlet consisting of a geriatrician, geriatric nurse practitioner, clinical pharmacist, licensed practical nurse, nurse care manager, social worker, and dietitian. GERIATRIC-PACT operates with increased ancillary support compared to Primary Care PACT. Falls assessment patients were referred by primary care providers and were evaluated and treated by the GERIATRIC-PACT teamlet, including ordering of tests and medication adjustment, with an average of two visits and active follow-up for one year.

Intervention Type: OTHER

Other Intervention Names

Falls Clinic

Eligibility Criteria

Inclusion Criteria

• Community-dwelling frail elderly with history of fall

Exclusion Criteria

• Severe dementia

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Powers, James S., M.D.

INDIV

Sponsor Role: lead

Responsible Party

James S. Powers, MD

Associate Clinical Director, TVHS GRECC

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

James Powers, MD

Role: PRINCIPAL_INVESTIGATOR

TVHS GRECC

Locations

TVHS Nashville Campus

Nashville, Tennessee, United States

Countries

United States

References

Michael YL, Whitlock EP, Lin JS, Fu R, O'Connor EA, Gold R; US Preventive Services Task Force. Primary care-relevant interventions to prevent falling in older adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2010 Dec 21;153(12):815-25. doi: 10.7326/0003-4819-153-12-201012210-00008.

Reference Type: RESULT

PMID: 21173416 (View on PubMed)

Chang JT, Morton SC, Rubenstein LZ, Mojica WA, Maglione M, Suttorp MJ, Roth EA, Shekelle PG. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ. 2004 Mar 20;328(7441):680. doi: 10.1136/bmj.328.7441.680.

Reference Type: RESULT

PMID: 15031239 (View on PubMed)

Moyer VA; U.S. Preventive Services Task Force. Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012 Aug 7;157(3):197-204. doi: 10.7326/0003-4819-157-3-201208070-00462.

Reference Type: RESULT

PMID: 22868837 (View on PubMed)

Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gottschalk M, Koch ML, Trainor K, Horwitz RI. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994 Sep 29;331(13):821-7. doi: 10.1056/NEJM199409293311301.

Reference Type: RESULT

PMID: 8078528 (View on PubMed)

Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011 Jan;59(1):148-57. doi: 10.1111/j.1532-5415.2010.03234.x.

Reference Type: RESULT

PMID: 21226685 (View on PubMed)

Other Identifiers

840

Identifier Type: -

Identifier Source: org_study_id