Failure of a Multifactorial Intervention to Prevent Serious Falls

Many factors (e.g., neurological and musculoskeletal conditions, tripping hazards, adverse effects of medications) contribute to falls in older adults; therefore, a comprehensive multifactorial approach to fall prevention would seem to be appropriate. In this cluster-randomized trial, conducted in 86 U.S. primary care practices, ≈5500 community-dwelling patients (age, ≥70) at high risk for fall injuries received a multifactorial intervention (delivered by specially trained nurses) or usual care (control group). The intervention consisted of assessment of individual risk factors for falling, recommendations given to participants and caregivers, development and implementation of an individualized “care plan,” and periodic follow-up.

The primar…