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Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017
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Rich Fry ,
Ashley Akbari ,
Sarah Rodgers,
Alan Watkins ,
Sarah Hillcoat-Nalletamby,
Neil Williams,
Silviya Nikolova,
David Meads,
Andy Clegg
Age and Ageing, Volume: 51, Issue: 1
Swansea University Authors:
Joe Hollinghurst, Helen Daniels , Rich Fry , Ashley Akbari , Alan Watkins , Sarah Hillcoat-Nalletamby
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DOI (Published version): 10.1093/ageing/afab201
Abstract
Backgroundfalls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.Aimdetermine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood o...
| Published in: | Age and Ageing |
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| ISSN: | 0002-0729 1468-2834 |
| Published: |
Oxford University Press (OUP)
2021
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa58465 |
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| Abstract: |
Backgroundfalls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.Aimdetermine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls.Study Designretrospective longitudinal controlled non-randomised intervention cohort study.Settingour cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service.Methodswe created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression.Resultscompared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%).ConclusionsC&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance. |
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| Keywords: |
older people, falls prevention, frailty, falls |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
BHF_/British Heart Foundation/United Kingdom;
HCRW_SCF-18-1504/HCRW/HCRW_/United Kingdom;
WT_/Wellcome Trust/United Kingdom;
CSO_/Chief Scientist Office/United Kingdom;
HCRW_HRG-16-1325/HCRW/HCRW_/United Kingdom;
HCRW_SCG-19-1654/HCRW/HCRW_/United Kingdom;
MRC_/Medical Research Council/United Kingdom;
BEHA/41/DMT_/The Dunhill Medical Trust/United Kingdom |
| Issue: |
1 |