Does the New Fall- and Fracture Prevention Initiative in Oslo Have Effect?

NCT ID: NCT05680714

Last Updated: 2023-01-11

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 121000 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2012-01-01
• Study Completion Date: 2024-12-01

Brief Summary

The goal of this controlled before and after study is to evaluate a new patient pathway for patients 65 years and older who have suffered a fall injury.

The main questions the study aims to answer are whether this preventive initiative with improved care coordination reduces risk of subsequent hip fractures, admittance to nursing homes or death.

Researchers will compare two boroughs in Oslo who implemented the new patient pathway with the 13 other boroughs who did not reorganize their follow-up, but continued their care as usual.

Detailed Description

The study is an evaluation of a new patient follow-up for fall prevention in Oslo with improvement of coordination of care for elderly at risk of fall injuries.

The intervention were introduced to the boroughs of Nordstrand and Østensjø, which are compared to the other 13 boroughs of Oslo in this controlled before and after study.

THE COHORT

All persons 65 years and older in Oslo are included in Oslo Fall Cohort and we follow all cohort participants prospectively.

OUTCOME VARIABLES

• Hip fracture
• Long term admittance to nursing home
• Death

TIMELINE

The investigators have defined the following dates as the start of intervention:

1. Start of intervention in Nordstrand borough is set to January 1, 2015.

2. Start of intervention Østensjø borough is set to September 1, 2016.

In the main analysis, fallers from the two intervention boroughs, Nordstrand and Østensjø, will be compared with fallers from the control boroughs during the intervention. Any differences between the intervention and control boroughs before the intervention started will be taken into account.

Data on all participants are available from 2010, and the participants will be followed from January 2012 until December 2019.

For each analysis, persons with a hip fracture or living in a nursing home at baseline will be excluded.

The analysis in the evaluation is based on registry data and no analysis relating the intervention to the outcomes has been done before registration in clinicaltrials.gov.

Conditions

Fall Injury; Hip Fractures

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: PROSPECTIVE

Study Groups

FALLERS IN THE INTERVENTION BOROUGHS

Fallers 65+ years from the borough of Nordstrand from January 1. 2015 Fallers 65+ years from the borough of Østensjø from September 1. 2016

Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention

Intervention Type: OTHER

FALLERS IN THE CONTROL BOROUGHS

Fallers 65+ years from all the 13 other boroughs of Oslo.

Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

No interventions assigned to this group

NON-FALLERS

All non-fallers 65+ years from all Oslo boroughs.

No interventions assigned to this group

Interventions

Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention

Intervention Type: OTHER

Other Intervention Names

Needs assessment and user involvement; Casefinding with identifying high risk individuals; Single point of entry to care in the boroughs; Cross sectoral plan for follow-up with role clarification; Interdisciplinary teams; Tools for multifactorial falls and fracture risk assessment (checklists for GP, home visits, injury clinic, osteoporosis); Information sharing; Primary and specialist care referral pathways; Targeted interventions (Ex: exercise, home safety, osteoporosis treatment, deprescribing, medical assessment); Champions to create enthusiasm and carry the intervention forward; Collaborative education of health professionals; Technology enablers in the electronic patients records

Eligibility Criteria

Inclusion Criteria

• 65 years or older
• Living on Oslo, Norway in the period January 1. 2012 - December 31. 2019

Exclusion Criteria

• Hip fracture before baseline
• Living in nursing home at baseline

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Oslo

OTHER

Sponsor Role: collaborator

Oslo University Hospital

OTHER

Sponsor Role: collaborator

Oslo Municipality

OTHER_GOV

Sponsor Role: collaborator

Norwegian Institute of Public Health

OTHER_GOV

Sponsor Role: lead

Responsible Party

Haakon Eduard Meyer

Principal Investigator, Senior Medical Officer, Professor in Epidemiology and Preventive Medicine

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Gro Idland, PhD

Role: STUDY_DIRECTOR

Municipality of Oslo, Department of Health

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

296587

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

RCN296587

Identifier Type: -

Identifier Source: org_study_id