- Title
- Fall-related health service use in Stepping On programme participants and matched controls: a non-randomised observational trial within the 45 and Up Study
- Creator
- Paul, Serene S.; Khalatbari-Soltani, Saman; Dolja-Gore, Xenia; Clemson, Lindy; Lord, Stephen R.; Harvey, Lara; Tiedemann, Anne; Close, Jacqueline C. T.; Sherrington, Cathie
- Relation
- Age and Ageing Vol. 51, Issue 12, no. afac272
- Publisher Link
- http://dx.doi.org/10.1093/ageing/afac272
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: Falls and fall-related health service use among older adults continue to increase. The New South Wales Health Department, Australia, is delivering the Stepping On fall prevention programme at scale. We compared fall-related health service use in Stepping On participants and matched controls. Methods: A non-randomised observational trial was undertaken using 45 and Up Study data. 45 and Up Study participants who did and did not participate in Stepping On were extracted in a 1:4 ratio. Rates of fall-related health service use from linked routinely collected data were compared between participants and controls over time using multilevel Poisson regression models with adjustment for the minimally sufficient set of confounders identified from a directed acyclic graph. Results: Data from 1,452 Stepping On participants and 5,799 controls were analysed. Health service use increased over time and was greater in Stepping On participants (rate ratios (RRs) 1.47-1.82) with a spike in use in the 6 months prior to programme participation. Significant interactions indicated differential patterns of health service use in participants and controls: stratified analyses revealed less fall-related health service use in participants post-programme compared to pre-programme (RRs 0.32-0.48), but no change in controls' health service use (RRs 1.00-1.25). Gender was identified to be a significant effect modifier for health service use (P < 0.05 for interaction). Discussion: Stepping On appeared to mitigate participants' rising fall-related health service use. Best practice methods were used to maximise this study's validity, but cautious interpretation of results is required given its non-randomised nature.
- Subject
- accidental falls; health service utilisation; older adults; fall prevention; older people
- Identifier
- http://hdl.handle.net/1959.13/1495034
- Identifier
- uon:53964
- Identifier
- ISSN:0002-0729
- Rights
- © The Author (s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial-NoDerivs licence(http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work properly cited. For commercial re-use, please contact journals.permissions@oup.com
- Language
- eng
- Full Text
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