Abstract
OBJECTIVES--To assess whether intervention by a health visitor could reduce the number of fractures, over a four year period, in those aged 70 and over. DESIGN--Randomised, controlled trial; randomisation by household. SETTING--General practice in a market town. SUBJECTS--Of 863 patients aged 70 and over on the practice records, 674 were traced and successfully interviewed; 350 were assigned to the intervention group, 324 as controls. INTERVENTION--The people in the intervention group were allocated to the care of a health visitor. The approach was four pronged: assessment and correction of nutritional deficiencies, including reducing smoking and alcohol intake; assessment and referral of medical conditions such as heart block or inappropriate medication; assessment and correction of environmental hazards in the home such as poor lighting; assessment and improvement of fitness--for example, exercise classes for the moderately fit. The intervention continued for four years. MAIN OUTCOME MEASURE--Fracture rate over four years. RESULTS--The incidence of fractures was 5% (16/350) in the intervention group and 4% (14/324) in the control group (difference not significant). CONCLUSIONS--A health visitor visiting a group of people aged 70 and over and using simple preventive measures had no effect on the incidence of fractures.
Full text
PDF


Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Boyce W. J., Vessey M. P. Rising incidence of fracture of the proximal femur. Lancet. 1985 Jan 19;1(8421):150–151. doi: 10.1016/s0140-6736(85)91915-4. [DOI] [PubMed] [Google Scholar]
- Greatorex I. F. Proximal femoral fractures: an assessment of the outcome of health care in elderly people. Community Med. 1988 Aug;10(3):203–210. doi: 10.1093/oxfordjournals.pubmed.a042407. [DOI] [PubMed] [Google Scholar]
- Hendriksen C., Lund E., Strømgård E. Consequences of assessment and intervention among elderly people: a three year randomised controlled trial. Br Med J (Clin Res Ed) 1984 Dec 1;289(6457):1522–1524. doi: 10.1136/bmj.289.6457.1522. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lewis A. F. Fracture of neck of the femur: changing incidence. Br Med J (Clin Res Ed) 1981 Nov 7;283(6301):1217–1220. doi: 10.1136/bmj.283.6301.1217. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Prudham D., Evans J. G. Factors associated with falls in the elderly: a community study. Age Ageing. 1981 Aug;10(3):141–146. doi: 10.1093/ageing/10.3.141. [DOI] [PubMed] [Google Scholar]
- Tulloch A. J., Moore V. A randomized controlled trial of geriatric screening and surveillance in general practice. J R Coll Gen Pract. 1979 Dec;29(209):733–740. [PMC free article] [PubMed] [Google Scholar]
- Vetter N. J., Jones D. A., Victor C. R. A health visitor affects the problems others do not reach. Lancet. 1986 Jul 5;2(8497):30–32. doi: 10.1016/s0140-6736(86)92570-5. [DOI] [PubMed] [Google Scholar]
- Vetter N. J., Jones D. A., Victor C. R. Effect of health visitors working with elderly patients in general practice: a randomised controlled trial. Br Med J (Clin Res Ed) 1984 Feb 4;288(6414):369–372. doi: 10.1136/bmj.288.6414.369. [DOI] [PMC free article] [PubMed] [Google Scholar]