@article{ref1,
title="Older people's participation in and engagement with falls prevention interventions in community settings: An augment to the Cochrane systematic review",
journal="Age and ageing",
year="2012",
author="Nyman, Samuel R. and Victor, Christina R.",
volume="41",
number="1",
pages="16-23",
abstract="Background: Randomized controlled trials (RCTs) of fall prevention conducted in community settings have recently been systematically reviewed.  Objective: to augment this review by analysing older people's participation in the trials and engagement with the interventions.  Design: review of the 99 single and multifactorial RCTs included in the Cochrane systematic review of falls prevention interventions.Setting: community.Participants: adults aged 60+/mean age minus one standard deviation of 60+.  Methods: calculated aggregate data on recruitment (proportion who accepted the invitation to participate), attrition at 12 month follow-up (loss of participants), adherence (to intervention protocol) and whether adherence moderated the effect of interventions on trial outcomes.  Results: the median recruitment rate was 70.7% (64.2-81.7%, n = 78). At 12 months the median attrition rate including mortality was 10.9% (9.1-16.0%, n = 44). Adherence rates (n = 69) were ≥80% for vitamin D/calcium supplementation; ≥70% for walking and class-based exercise; 52% for individually targeted exercise; approximately 60-70% for fluid/nutrition therapy and interventions to increase knowledge; 58-59% for home modifications; but there was no improvement for medication review/withdrawal of certain drugs. Adherence to multifactorial interventions was generally ≥75% but ranged 28-95% for individual components. The 13 studies that tested for whether adherence moderated treatment effectiveness produced mixed results.  Conclusions: using median rates for recruitment (70%), attrition (10%) and adherence (80%), we estimate that, at 12 months, on average half of community-dwelling older people are likely to be adhering to falls prevention interventions in clinical trials.<p /> <p>Language: en</p>",
language="en",
issn="0002-0729",
doi="10.1093/ageing/afr103",
url="http://dx.doi.org/10.1093/ageing/afr103"
}