Table 3. Characteristics of included studies*.
| Study | Group (I/C) | Sample size, Sex | Age (Y), (Mean ± SD) | Program detail | Outcome Measures | Results |
|---|---|---|---|---|---|---|
| Stark et al. (2021) | I | 155; 122 F, 33 M | 74.7 ± 7.4 | Three sessions provide to intervention group consist of 1) home hazard assessment using The Westmead Home Safety Assessment. (2) Facilitated home modifications home modification by interventionist (3) Complete installation and training. | • Falls • Daily activity performance |
• No difference for outcome of fall hazard. • Thirty-eight percent reduction in the rate of falling in the intervention group compared with the control group. • No difference in daily activity performance. |
| C | 155; 122 F, 33 M |
75.1 ± 7.7 | Usual care | |||
| Cockayne et al. (2021) | I | 430; 285 F, 185 M | 79.9 ± 6.4 | The Westmead Home Safety Assessment was used to examine home hazards, and an OT modify home relate danger. | • Falls • Fear of falling • Time to fall. • Cost-effectiveness. |
• An increase of fall rate in the intervention group relative to usual care. • No difference between the two groups of participants reporting a fear of falling. • No difference in time to fall between the intervention and usual care groups. • The intervention was associated with additional costs but was less effective. |
| C | 901; 587 F, 314 M | 80.2 ± 6.3 | Usual care from their GP and other health-care professionals | |||
| Chu et al. (2017) | I | 95; 60 F, 30 M | 78.6 ± 6 | The OT Fall Reduction Home Visit Program consisted of an environmental hazard’s evaluation and the Westmead Home Safety Assessment to identify environmental hazards, and a daily life routine assessment. The follow-up telephone call regarding home modification and assistive devices 2 months after the home visit. | • Number of fallers and repeated fallers • Number of falls and recurrent falls • Time until first fall |
• The percentage of fallers over 1 year was 13.7% in the IG and 20.4% in the CG. • Significant differences in the number of fallers (ρ = 0.03) and the number of falls (ρ = 0.02) between the two groups over 6 months. • Significant differences in survival analysis for first fall at 6 months, but not 9 or 12 months. |
| C | 103; 76 F, 27 M | 78.1 ± 6.1 | A single visit by a research assistant who had no professional training and no knowledge of fall prevention | |||
| Kamei et al. (2015) | I | 67; 56 F, 11 M | 75.7 ± 6.7 | HHMP group was provide for intervention group consist of a residential safety self-assessment for assessing home hazard and using a displayed 60 cm × 60 cm residential mock-up for practice. | • Falls • Fall prevention awareness. • Home modification |
• The HHMP group achieved a 10.9% reduction in overall falls compared with the control group. • Significant increase in fall prevention awareness in the HHMP group between baseline and 52 weeks (ρ <0.05). • The highest rates of modification were addressing “clutter” on the floor (82.1% in HHMP and 61.1% in control) |
| C | 63; 9 F, 63 M | 75.8 ± 6.4 | Knowledge about falls risk, safety, and nutrition. A short talk on health and aging including demonstrate foot care, were provide by physician research and nurse. | |||
| Pighills et al. (2011) | I | 87; 62 F, 25 M | 78 ± 5 | Home hazard assessment, using the Westmead Home Safety Assessment, conducted in the home. Potential fall hazards were discussed, The OT suggested possible solutions and agreed on recommendations. A follow-up telephone contact was made after 4 weeks, and another telephone contact was made after 12 months. |
• Falls • Quality of life • Barthel Index • Westmead Home Safety Assessment |
• Fall rate in the OT group was approximately half that in the control group. • No difference was found between OT groups and the control group in independence in the QOL (ρ = 0.98). • No statistically significant difference in independence in ADLs between the OT group and controls (ρ = 0.87). |
| C | 78; 52 F, 26 M | 80 ± 7 | Usual care | |||
| La Grow et al. (2006) | I | 100 | NR | A home safety checklist, using modified version of the Westmead home safety assessment checklist, was provided by an OT. The OT facilitated provision of and payment for new equipment, depending on price and type of item. Second home visit was required the OT to confirm that the equipment had been installed. | Falls (hazard and non-hazard related) | Hazard-related and non–hazard-related falls were reduced in the home safety group compared with the control group. |
| C | 96 | NR | ||||
| Campbell et al. (2005) | I | 100; 66 F, 24 M | 83.1 ± 4.5 | Home safety program included a home safety checklist using a modified version of the Westmead home safety assessment checklist with referral and recommendations to reduce home hazards and adherence using a telephone interview six months after study entry by an OT. | • Fall and injury • Program cost |
• Home safety program participants had 41% fewer falls than those who did not receive this program. • No significant difference was found in reduction in falls at home compared with falls away from the home. • The home safety program cost $432 per fall prevented. |
| C | 96; 67 F, 29 M | 84 ± 4.9 | Sixty-min social visits in the home during the first six months of the trial. | |||
| Gerson, Camargo Jr & Wilber (2005) | I | 118; 67 F, 51 M | 75.4 ± 6.8 | Two brochures produced by the Centers for Disease Control and Prevention consist of (1) checklist of home hazards (2) the suggestions included exercise, vision check, medication review, and home modification. During the 1-month telephone call they would be asked questions about the brochures. | • Falls • Self-report of change in the home |
• Almost half of ED population reported having had a fall in the prior year. • 11 percent of patients who fell made a change in home compared with 6% of those who did not fall. • 9% of the control group and 8% of the intervention group made safety changes to the home environment. |
| C | 279; 180 F, 99 M | 75.7 ± 7.1 | A telephone call and be asked questions about home safety and receive information about how they could make their home safer. | |||
| Nikolaus & Bach (2003) | I | 181; 131 F, 50 M | 81.2 ± 6.3 | Home visit to inform about the possible fall risks in their home, to give advice on possible changes of the home environment, to facilitate any necessary home modifications, and to teach the persons in the use of technical and mobility aids when necessary. One year later, home visits were made for all participants. | • Number of falls • Type of recommended home modifications • Compliance with recommendations |
• 163 falls in the intervention group and 204 falls in the control group. • 31% lower fall rate in the intervention group than for the control group, but the proportion of frequent fallers did not significantly differ between the groups. • At least one recommended change had been implemented (compliance rate 75.7%) • The compliance rate in the use of shower seats, emergency calls, and grab bars was high. |
| C | 133; 131 F, 2 M | 81.0 ± 6.5 | Not receive any type of home visit | |||
| Pardessus et al. (2002) | I | 30; 23 F, 7 M | 83.51 ± 9.08 | Home visit to identify environmental hazards, and modifications were recommended. Simple home hazard removal was accomplished during assessment, if possible. Whenever a hazard could not be removed, the OT provided advice on how to live more safely with the hazards. Follow-up was provided by phone every month for 6 month and at 12 months. | • Falls • Fall-related institutionalization and death at 6 and 12 months. |
• 28 patients had a fall recurrence; 15 were in the control group and 13 in the intervention group but not significant in the different. • The mean number of fall recurrence was 0.72 ± 0.19 (control group, 0.82 ± 0.22; intervention group, 0.68 ± 0.16; not statistically significant). • The rate of falls, institutionalization, and death were not significantly different between the two groups. |
| C | 30; 24 F, 6 M | 82.9 ± 6.3 | Therapeutic modifications from PT during hospitalization and those were informed on home safety and possible social assistance. | |||
| Stevens et al. (2001) | I | 570; 306 F, 264 M | 76 NR | The intervention consisted of three strategies: a home hazard assessment, the installation of free safety devices, and an educational strategy to empower elderly to remove or modify home hazards. | Falls | • No significant reduction in the intervention group in the incidence rate of falls. • No reduction in the rate of all falls or the rate of falls inside the home. • No significant reduction in the rate of injurious falls in intervention subjects. |
| C | 1,167; 602 F, 565 M | 76 NR | Acted to reduce the number of fall hazards in homes, having been alerted by the daily calendar to the purpose of the study and potential causes of falls. | |||
| Cumming et al. (1999) | I | 264; 149 F, 115 M | 76.4 ± 7.1 | Home visit and gave specific recommended home modifications conducted by an OT. Program adherence by the OT telephoned about 2 weeks after visit. | Falls | • 36% of subjects in the intervention group had at least one fall during follow-up, compared with 45% of controls (ρ = .05). • The intervention was effective only among subjects (n = 206) who reported having had one or more falls during the year before recruitment into the study. |
| C | 266; 154 F, 112 M | 77.2 ± 7.4 | No home visits. |
Notes.
- I
- intervention group
- C
- control group
- NR
- not reported
- M
- male
- F
- female
*
The review was performed after PROSPERO registration and repeated to ensure the update new research on January 2023.