Specialist GP Nikki Vadgama provides some tips to make your next paediatric eczema consult easier. She includes a review of new guidelines, resources, websites and medications for paediatric eczema management
Changing the environment to prevent falls in older people
Vault Navigation
Changing the environment to prevent falls in older people
What are the effects of environmental interventions, such as removing fall hazards, assistive technology, education and home modifications, on the prevention of falls in older people living in the community?
There is high-certainty evidence that home fall-hazard interventions are effective in reducing the rate of falls and the number of fallers when targeted at people at higher risk of falling (based on history of falling, recent hospitalisation, and other risk factors). For the selected higher-risk category, based on an illustrative risk of 1847 falls per 1000 person-years in the control group, there were 702 (38%) fewer falls per 1000 person-years in the home fall-hazard intervention group. These interventions aim to reduce falls by assessing fall hazards and making environmental safety adaptations (eg, non-slip strips on steps) or behavioural changes (eg, avoiding clutter).
There was no evidence of effect when interventions were targeted to people not selected for risk of falling. It makes sense that this intervention, which focuses on the home environment and interaction of the person within their environment, would benefit those at higher risk rather than the general community of older people.
It was unclear whether assistive technology, education interventions or home modifications reduce falls, but this evidence was all of low or very-low quality, which was in part due to very low sample numbers.
Few studies provided fracture, medical attention, hospital admission, health-related quality of life or adverse events data.
The majority of trials in this review excluded older people who were cognitively impaired; therefore, these results may not be applicable in that high-risk group.
Falls and fall-related injuries are common. One-third of community-dwelling people aged over 65 fall each year. Falls can have serious consequences, including restricting activity or institutionalisation. This review assessed interventions aimed at reducing the number of falls, which could hopefully result in reduced ongoing consequences such as hospital admissions and fractures.
Clemson L, et al. Environmental interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2023;3:CD013258. This review contains 22 trials with a total of 8463 participants.