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. 2008 Oct 1;8(2):1–78.
Study Population Intervention and Referent Group (N) Number of Visits and Description of Intervention Personnel (e.g., Nurse, OT) Follow-Up Outcomes Measured Results
Gillespie: Cochrane Review (2003) (44)

  • Elderly

  • RCTs

  • Community-dwelling


Fallers in year prior (n=3 studies) No falls in year prior (n=1) Fallers and non-fallers in year prior (n=3)		 Home safety intervention alone vs. control

  • Varied

 Varied Varied Number of people falling Results from meta-analysis:
Fallers in year prior RR: 0.66 (0.54–0.81)
No falls in year prior, RR: 1.03 (0.75–1.41)
Fallers and non-fallers in year priorRR: 0.85 (0.74–0.96)
Day (2002) †(170)

  • Aged 70+

 Home hazard intervention (n=135) vs. no intervention (n=137)

  • One assessment visit, and one by home maintenance staff if labour and materials were required

  • Modifications included hand rails, modifications to floor coverings, contrast edging, and stair/ramp maintenance

 Trained assessor 18 months Number of falls, number of home hazards

  • RR, 0.92 (0.78–1.08), P = .29

  • % estimated reduction in annual fall rate, 3.1 (−2.0 to 9.7)
Nikolaus (2003)† (58)

  • Mean age 81

  • Recruited as inpatients in geriatric clinic

 Home intervention team (N=140) vs. control (N=139)

  • One home visit while inpatient to evaluate home and prescribe technical aids

  • After discharge, at least 1 more visit to inform patient of risks, give advice for modifications, facilitate modifications

 Nurse, physiotherapist, occupational therapist, social worker 1 year Death or nursing home placement, number of falls

  • IRR falls, 0.69 (0.51–0.97), P = .032

  • IRR falls in intervention group with at least 1 modification after 12 months, 0.64 (0.37–0.99, P = .047)

  • IRR falls in intervention group with no modification after 12 months, not significant

  • No difference between no. died vs. no. moved to LTC home
Pardessus (2002)† (171)

  • Aged 65+

  • Recruited after fall hospitalization

 Home visit to assess environmental modifications(N=30) vs. control(N=30)

  • Single home visit during hospitalization to assess home hazards and remove any with patient consent

  • Hospital social worker contacted to assess problems that were encountered

 Physical medicine and rehabilitation doctor, ergotherapist and hospital social worker Every month for 6 months, and at 12 months Fall, hospital admission, LTC home admission, death

  • No significant difference in recurring fall, number of recurring falls, LTC home admission or rehospitalization.

  • 40% controls rehospitalized, 23% cases.

  • May be a power problem because of small sample size
*

IRR refers to incidence rate ratio; no., number; OT, occupational therapist; RCT, randomized controlled trial; RR, relative risk;

†

Also identified in Cochrane review