A scoping review of multi-factorial tools for preventing falls in adults

Introduction

There are numerous risk factors for falling in older adults, and world and UK guidance advocate adopting a multifactorial approach to falls prevention. Many falls risks can be addressed through actions for which clinical training is not required (e.g., removing trip hazards or providing advice about footwear). Patients’ access to falls prevention could be improved by supporting non-clinicians to use a standardised approach to identify risks and preventative actions. We aimed to identify risks and actions described in the published literature that could be incorporated into a novel falls prevention tool for delivery by non-clinicians.

Method

We conducted a scoping review of articles describing tools that support non-clinicians to assess multiple risk factors for falling and identify interventions to reduce these risks. Searches of MEDLINE, Embase, CINAHL, PsychINFO and SafetyLit, were undertaken and retrieved articles underwent narrative synthesis.

Results

After the screening of 7,143 identified articles, and reviewing of 368 full texts, nine studies were included. These comprised six randomised trials and three quasi-experimental studies. Three studies (all trials) reported tools being associated with statistically significant reductions in falls rates or risk of falling. Components of tools from included articles were collated to create a list of 14 modifiable, assessable risks: medications; home hazards; footwear and condition of the feet; balance, gait and strength; medical history; vision and hearing; continence; walking aid use; diet; lack of assistance; history of falls; cognition; fear of falling; sleep, living alone and negative affect.

Conclusions

We identified falls risks and related preventative actions in the published literature that could be incorporated into a novel falls prevention tool for delivery by non-clinicians. Supporting non-clinician practitioners to implement multifactorial falls prevention may prevent falls, lessen associated injury and mortality rates and healthcare use and costs, and result in greater numbers benefitting from evidence-based falls prevention.