Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial

Tan, Pey June and Khoo, Ee Ming and Chinna, Karuthan and Saedon, Nor 'Izzati and Zakaria, Mohd Idzwan and Ahmad Zahedi, Ahmad Zulkarnain and Ramli, Norlina Mohd and Khaliddin, Nurliza and Mazlan, Mazlina and Chee, Kok Han and Abidin, Imran Zainal and Nalathamby, Nemala and Mat, Sumaiyah and Jaafar, Mohamad Hasif and Khor, Hui Min and Khannas, Norfazilah Mohamad and Majid, Lokman Abdul and Tan, Kit Mun and Chin, Ai-Vyrn and Kamaruzzaman, Shahrul Bahyah and Poi, Philip Jun Hua and Morgan, Karen and Hill, Keith D. and MacKenzie, Lynette and Tan, Maw Pin (2018) Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial. PLoS ONE, 13 (8). e0199219. ISSN 1932-6203

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Objective To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. Design Pragmatic, randomized-controlled trial. Setting Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia. Participants Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months. Intervention Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment. Primary and secondary outcome measures The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall. Results Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613–1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846–1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782–1.522)] and mortality rate [RR = 0.896 (95% CI 0.335–2.400)] did not differ between groups. Conclusion Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations.

Item Type: Article
Uncontrolled Keywords: Accidental Falls; Accidents, Home; Aged; Aged, 80 and over; Cardiovascular Diseases; Emergency Service, Hospital; Environment Design; Exercise Therapy; Female; Humans; Malaysia; Male; Patient Admission; Precision Medicine; Primary Prevention; Vision Disorders
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 27 Feb 2019 03:19
Last Modified: 27 Feb 2019 03:19

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