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Fall-prevention education delivered during or after hospitalization can be an effective means of reducing falls among older adults

Lee DC, Pritchard E, McDermott F, et al.  Falls prevention education for older adults during and after hospitalization: A systematic review and meta-analysis Health Education Journal. 2014;73 (5):530-544.  

Review question

How effective are patient education interventions at reducing falls and increasing the uptake of fall-prevention strategies among older adults during and after hospitalization?

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Falls are frequent, adverse events common among older adults in both community and hospital settings. Older adults are particularly vulnerable to falls in the four weeks following hospital discharge.

Recent literature has suggested that patients can benefit from fall-prevention education interventions.

The aim of this review was to assess patient-education interventions for reducing the risk of falls among older adults in both the inpatient and post-discharge settings.

How the review was done

A detailed search of a number of electronic databases for studies published up to November 2012 was conducted. Studies that focused on patient education for fall prevention in the hospital or post-discharge community settings were included in the review.

A total of 1,382 studies were identified in searches, and 26 were included in the review after assessments for eligibility.

The authors did not acknowledge any funding sources for this review.

What the researchers found

The interventions evaluated in the review included patients being taught fall-prevention strategies using a number of approaches, such as face-to-face interactions with healthcare professionals, videos, and written materials (e.g. pamphlets).

Patients educated through a combination of these approaches were more knowledgeable and confident in their ability to apply fall-prevention strategies to their lives compared to patients who received educational material alone. When face-to-face interaction was not available, videos were more effective at educating patients than written materials such as pamphlets.

Hospital-based education interventions were not always effective at reducing falls, and interventions were not effective when delivered to patients who were cognitively impaired.

While education did reduce falls when delivered in-hospital and after discharge, it did not appear to reduce other important outcomes such as rates of fall-related injuries, and fall-related emergency department admissions.

Conclusion

Older adults who are educated about fall-prevention strategies will have lower rates of falls in hospitals and in post-discharge settings, although they may not have lower rates of falls resulting in injuries, or fall-related emergency department admissions. More research is needed to assess education as a stand-alone strategy, and to determine the costs of this approach.

This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.