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Engagement of older adults in STRIDE's multifactorial fall injury prevention intervention

McMahon, Siobhan K. ; Greene, Erich J. ; Latham, Nancy ; Peduzzi, Peter ; Gill, Thomas M. ; Bhasin, Shalender ; Reuben, David B.

Journal of the American Geriatrics Society (JAGS), 2022-11, Vol.70 (11), p.3116-3126 [Periódico revisado por pares]

Hoboken, USA: John Wiley & Sons, Inc

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  • Título:
    Engagement of older adults in STRIDE's multifactorial fall injury prevention intervention
  • Autor: McMahon, Siobhan K. ; Greene, Erich J. ; Latham, Nancy ; Peduzzi, Peter ; Gill, Thomas M. ; Bhasin, Shalender ; Reuben, David B.
  • Assuntos: Aged ; Aged, 80 and over ; Balance ; Clinical Investigation ; Clinical Investigations ; Exercise ; Exercise Therapy ; Fall Prevention ; Falls ; Gait ; Humans ; Injury prevention ; Older Adults ; Older people ; Patient Engagement ; Patients ; Prevention ; Primary Care ; Risk Factors
  • É parte de: Journal of the American Geriatrics Society (JAGS), 2022-11, Vol.70 (11), p.3116-3126
  • Notas: Funding information
    Boston Claude D. Pepper Older Americans Independence Center, Grant/Award Number: P30AG013679; National Institute on Aging, Grant/Award Number: 501AG048270; Patient‐Centered Outcomes Research Institute, Grant/Award Number: 5U01AG048270; University of Minnesota CTSI, National Center for Advancing Translational Sciences, Grant/Award Numbers: KL2TR000113, Ul1TR000114; Yale Claude D. Pepper Older Americans Independence Center, Grant/Award Number: P30AG021341; Yale CTSA, National Center of Advancing Translational Sciences, Grant/Award Number: UL1TR000142
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    Funding information Boston Claude D. Pepper Older Americans Independence Center, Grant/Award Number: P30AG013679; National Institute on Aging, Grant/Award Number: 501AG048270; Patient‐Centered Outcomes Research Institute, Grant/Award Number: 5U01AG048270; University of Minnesota CTSI, National Center for Advancing Translational Sciences, Grant/Award Numbers: KL2TR000113, Ul1TR000114; Yale Claude D. Pepper Older Americans Independence Center, Grant/Award Number: P30AG021341; Yale CTSA, National Center of Advancing Translational Sciences, Grant/Award Number: UL1TR000142
  • Descrição: Background Evidence‐based multifactorial fall prevention interventions in clinical practice have been less effective than expected. One plausible reason is that older adults' engagement in fall prevention care is suboptimal. Methods This was a post‐hoc analysis of 2403 older adults' engagement in a multifactorial fall prevention intervention in the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) pragmatic trial. Based on the direct clinical care level of the Patient and Family Continuum of Engagement (CE) framework, three indicators of progressively interactive engagement were assessed: (1) Consultation (receiving information), (2) Involvement (prioritizing risks), and (3) Partnership (identifying prevention actions). Drop off at each step was determined as well as predictors of engagement. Results The participants' engagement waned with increasingly interactive CE domains. Although all participants received information about their positive fall risk factors (consultation) and most (51%–96%) prioritized them (involvement), fewer participants (33%–55%) identified fall prevention actions (partnership) for most of their risk factors, except for strength gait or balance problems (95%). More participants (70%) identified home exercises than other actions. Finally, fall prevention actions were identified more commonly among participants who received two visits compared to one (OR = 2.33 [95% CI, 2.06–2.64]), were ≥80 years old (OR = 1.83 [95% CI, 1.51–2.23]), and had fewer fall risk factors (OR = 0.90 [95% CI, 0.83–0.99]). Conclusions The drop‐off in participants' engagement based on the level of their interaction with clinicians suggests that future multifactorial fall prevention interventions need to be more focused on interactive patient‐clinician partnerships that help older adults increase and maintain fall prevention actions. Our analyses suggest that more frequent contact with clinicians and more monitoring of the implementation and outcomes of Fall Prevention Care Plans could potentially improve engagement and help older adults maintain fall prevention actions.
  • Editor: Hoboken, USA: John Wiley & Sons, Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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