Patient Centred Clinical Approach and Number of Falls: A Potential Model for Falls Clinics

Introduction

A comprehensive geriatric assessment is recommended by the British Geriatrics Society with a comprehensive medical assessment, (CMA) being implied for the falling patients. But the data on its application and impact on falls is scanty. 

Methods

We implemented  a patient centred CMA to the patients referred to falls clinics, prospectively, to facilitate complex, multimorbid, multi-systemic medical diagnoses. The number of falls in the six months prior and six month  after the interventions were compared and statistically analysed. The same interventions were carried out on the second, and third cohort of patients.

Results:

Total of 77 patients were assessed during 2023-25, in three separate datasets. In the initial 30 patients, 83 newly diagnosed medical conditions were identified, and treated. Medications reviewed were 41. The total number of falls was 310. They reduced  to 54, (79.3% reduction, Mean reduction from 10.3 to 1.8, P< 0.01). The second set of data, in the  year 2024, for 24 patients, revealed the  number of falls reducing from  133 to 17, (5.5 falls per patient,  reduction was 87.2%).

The observations were repeated in the third year 2025, on 23 patients. The total number falls were 151 reducing to 15, (6.6 falls per patient, 90% reduction). After reviewing the literature, we found that, this was an unparalleled reduction in the number of falls.

The most common newly diagnosed medical causes of falls in these cohorts were peripheral neuropathy and orthostatic hypotension. 

Conclusion

A patient centred comprehensive medical assessment directed to the medical needs, and their treatments of the medical conditions,  and medications reviews, greatly reduce number of falls in the elderly by 79%-90%.