De Vries 2010.
Study characteristics | ||
Methods | RCT | |
Participants | Setting: Amsterdam, the Netherlands N = 217 Sample: people consulting ED or family physician after a fall (71% women) Age (years): mean 79.8 (SD 7.35) Inclusion criteria: aged ≥ 65 years; living independently or in assisted living facility; living near University Medical Center; history of fall in previous 3 months Exclusion criteria: unable sign informed consent or provide a fall history; cognitive impairment (MMSE < 24); fall due to traffic or occupational accident; living in nursing home; acute pathology requiring long‐term rehabilitation, e.g. stroke | |
Interventions | 1. Multidisciplinary assessment in geriatric outpatient clinic and individually tailored treatment in collaboration with patient's GP e.g. withdrawal of psychotropic drugs, balance and strength exercises, home hazard reduction, referral to specialists 2. Control: usual care | |
Outcomes | 1. Number of people falling 2. Number sustaining a fracture Other outcomes reported but not included in this review | |
Duration of the study | 1 year | |
Notes | Cost‐effectiveness analysis and cost utility analysis reported in Peeters 2011 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "computer‐generated random sequence" |
Allocation concealment (selection bias) | Low risk | Quote: "…opaque envelopes are numbered and filled with group names. When a participant is designated to the high‐risk group, the interviewer, who is unaware of the content, opens the envelope with the lowest number." (from protocol paper) |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Quote: "Participants, intervention caregivers, and interviewers could not be blinded to group assignment." but impact of non‐blinding unclear. |
Blinding of outcome assessment (detection bias) Falls and fallers | High risk | Not completely clear but study personnel stated to be non‐blinded, and falls self reported |
Blinding of outcome assessment (detection bias) Fractures | High risk | Quote: "By their response to a questionnaire sent 11⁄2 years after the first home visit, participants were asked to indicate whether they had sustained a fracture since the first home visit." Study personnel non‐blinded, and no confirmation of fractures from medical records. |
Incomplete outcome data (attrition bias) Fallers | Low risk | SeeAppendix 3 for method of assessment |
Risk of bias in recall of falls | Low risk | Quote: "For 1 year, the participants recorded each week whether they had fallen." "Once per 3 months the participants return a calendar sheet by mail. When no sheet is received, or when the sheet is completed incorrectly, we inquire by telephone whether, and if yes, when the participant has fallen in the past 3 months." |