Use of digital questionnaires to identify and manage fallers within a perioperative population

Background: Falls are a major cause of morbidity in adults aged over 65 years and are associated with increased peri-operative risk. Pre-operative assessment for elective general surgery offers an opportunity to identify patients at risk of falls and implement preventative interventions. Digital health tools may provide an efficient and scalable method for screening large patient populations.

Aim: To evaluate the use of a digital questionnaire to identify a history of falls in patients aged over 65 years awaiting elective general surgery and to assess subsequent clinical interventions.

Methods: A digital pre-assessment questionnaire incorporating falls screening was implemented for patients aged ≥65 years listed for elective general surgery. Data were collected prospectively from over 400 patients. The questionnaire assessed self-reported falls history and self reported frailty score. Completion accuracy, prevalence of falls, and downstream clinical actions were analysed.

Results: Over 400 patients completed the digital questionnaire. More than 10% of respondents reported at least one fall, completion accuracy was high, with only three questionnaires not completed accurately. Identification of a falls history prompted further evaluation in all affected patients, including a structured medication review to identify potential contributors such as polypharmacy or high-risk medications. The majority of patients who reported falls were provided with exercise-based advice aimed at improving strength and balance, and many were offered referral to balance or falls prevention classes. The digital approach enabled consistent identification of at-risk patients without significant additional clinical workload.

Conclusion: Use of a digital questionnaire is a feasible and effective method for identifying falls risk in patients over 65 years awaiting elective general surgery. The high completion accuracy demonstrates acceptability among older patients. Importantly, screening facilitated timely medication review and preventative interventions, including exercise advice and balance classes, which may reduce future falls and improve peri-operative outcomes. Digital falls screening should be considered as part of routine pre-operative assessment in older surgical patients