A Randomized Clinical Trial to Assess the Impact on an Emergency Response System on Anxiety and Health Care Use among Older Emergency Patients after a Fall

Lee, Jacques; Hurley, Mary Jane; Carew, Debra; Fisher, Rory H.; Kiss, Alex; Drummond, Neil

doi:10.1111/j.1553-2712.2007.tb02011.x

Cited by 11 publications

(26 citation statements)

References 32 publications

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“…Lee et al (2007) similarly reported no significant change in MFES scores for older patients with and without an alarm 30 days post discharge from an ED. It would appear in this study that while having an alarm did not necessarily make people less fearful of falling it did, however, have an impact on their behavior.…”

Section: Discussionmentioning

confidence: 82%

“…Of the existing studies, most have examined the effectiveness of personal alarms in terms of savings in the use of other more expensive services such as hospital and residential care. While some have demonstrated a reduction in hospital admissions and shorter hospital stays (Koch, 1984;McGadney-Douglass, 2001;Roush & Teasdale, 1997), others have not (Lee et al, 2007;Ruchlin & Morris, 1981;Sherwood & Morris, 1980).…”

Section: Introductionmentioning

confidence: 99%

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Personal emergency alarms: do health outcomes differ for purchasers and nonpurchasers?

Miguel¹,

Lewin

Burton

et al. 2017

Home Health Care Services Quarterly

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The objective of this study was to assess whether purchasing a personal alarm service makes a difference in a range of health outcomes for community dwelling older adults. The prospective cohort study involved 295 individuals for whom data on emergencies experienced at home were collected over a period of 12 months. Purchasers of alarms, compared to nonpurchasers, benefitted in terms of feeling more safe and secure and being more active around their home. Outcomes experienced after an emergency were similar for both groups with no differences found in terms of time spent on floor, or hospitalizations.

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Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Personal emergency alarms: do health outcomes differ for purchasers and nonpurchasers?

Miguel¹,

Lewin

Burton

et al. 2017

Home Health Care Services Quarterly

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“…The third categorization included four studies where the intervention was initiated at ED discharge and included a component of follow up or monitoring post discharge [22, 28, 29, 36]. These included a study of an intervention that used personal emergency response systems and a further three that provided a nurse led telephone or telehealth post discharge intervention.…”

Section: Resultsmentioning

confidence: 99%

“…The selection of ‘high-risk’ patients or those with poor baseline health with a background of chronic illness may be a reason for lack of intervention effect if the underlying chronic conditions increase the risk of admission [8, 26]. In contrast Lee et al, [29], did not restrict their patient sample to ‘high-risk’ patients and suggest that had they chosen the group most likely to benefit from the intervention a positive intervention effect may have been seen.…”

Section: Discussionmentioning

confidence: 99%

“…OR 1.92 (95% CI 0.68, 5.41).Non-randomised intervention. Low recruitment rate of eligible patients.ED initiated discharge interventions (discharged directly from ED)Personal emergency response systems (PERS)Lee et al, 2007, Canada [29]Patients ≥70 who presented to single urban ED after a fall identified as fit for discharge to own home. Patients recruited in ED or within 72 hours of discharge home.RCT (Single blind).Conventional discharge planning plus free use of personal emergency response systems (PERS).…”

Section: Methodsmentioning

confidence: 99%

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What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis

Crede

O’Keeffe

Mason

et al. 2017

BMC Health Serv Res

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BackgroundGlobally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient’s journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions.MethodsA rapid evidence synthesis, using a systematic literature search, was undertaken in the electronic data bases of MEDLINE, EMBASE, CINAHL, the Cochrane Library and Web of Science, for the years 2000–2014. Evidence included in this review was restricted to Randomised Controlled Trials (RCTs) and observational studies (with a control arm) reported in peer-reviewed journals. Studies evaluating interventions for patients with an acute exacerbation of a medical condition in the ED or acute care setting which reported at least one outcome related to ED attendance or unplanned admission were included.ResultsThirty papers met our inclusion criteria: 19 intervention studies (14 RCTs) and 11 controlled observational studies. Sixteen studies were set in the ED and 14 were conducted in an acute setting. Two studies (one RCT), set in the ED were effective in reducing ED attendance and hospital admission. Both of these interventions were initiated in the ED and included a post-discharge community component. Paradoxically 3 ED initiated interventions showed an increase in ED re-attendance. Six studies (1 RCT) set in acute care settings were effective in reducing: hospital admission, ED re-attendance or re-admission (two in an observation ward, one in an ED assessment unit and three in which the intervention was conducted within 72 h of admission).ConclusionsThere is no clear evidence that specific interventions along the patient journey from ED arrival to 72 h after admission benefit ED re-attendance or readmission. Interventions targeted at high-risk patients, particularly the elderly, may reduce ED utilization and warrant future research. Some interventions showing effectiveness in reducing unplanned ED attendances and admissions are delivered by appropriately trained personnel in an environment that allows sufficient time to assess and manage patients.

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Interventions for preventing falls in older people living in the community

Gillespie

Robertson

Gillespie

et al. 2009

Cochrane Database of Systematic Reviews

885

748

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A Randomized Clinical Trial to Assess the Impact on an Emergency Response System on Anxiety and Health Care Use among Older Emergency Patients after a Fall

Abstract: In contrast to previous studies, there was no evidence that a PERS reduced anxiety, fear of falling, or return to the ED among older persons discharged from the ED.

Cited by 11 publications

References 32 publications

Personal emergency alarms: do health outcomes differ for purchasers and nonpurchasers?

Personal emergency alarms: do health outcomes differ for purchasers and nonpurchasers?

What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis

Interventions for preventing falls in older people living in the community

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