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:10.1197/j.aem.2006.11.017

Cited by 23 publications

(14 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eight RCT’s [29–36], six CBA studies [37–42], and two NRCT’s [43, 44], fulfilled our inclusion criteria. Of the 16 included studies, five were conducted in the United States [32, 36, 39, 41, 43], four in Canada [29, 31, 34, 37], three in the United Kingdom [30, 40, 42], three in Australia [33, 35, 44], and one in Singapore [38]. The studies were published between 1996 and 2016 (median publication year = 2010; IQR = 2003 to 2013).…”

Section: Resultsmentioning

confidence: 99%

“…Despite the shared focus on the older adult patient population, included studies varied in population by age, health condition, and place and time of exposure to the intervention. Of the 16 studies, 10 included patients aged ≥65 years [30–32, 35, 36, 38, 40, 41, 43, 44], three included patients aged ≥75 years [33, 37, 42], two included patients aged ≥70 years [29, 34], and one included patients aged ≥60 years [39]. Seven studies further specified their inclusion criteria to: patients admitted to the ED with a medical diagnosis [35], a chronic disease [44], a traumatic injury [39], fall injuries [30, 34], increased risk of ED readmission [29, 35], and requiring outpatient follow-up – like assistance with activities of daily living (ADL) at home – after ED discharge [29, 36].…”

Section: Resultsmentioning

confidence: 99%

“…Of the 16 studies, twelve studies (75%) had a high risk of bias, most commonly due to inadequate randomization, allocation concealment, and blinding [30, 31, 33, 36–44]. Two studies (13%), both RCTs, had a low risk of bias [29, 34]. Two other RCTs (13%) had a moderate risk of bias [32, 35].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review

Hesselink¹,

Sir

Schoon

2019

BMC Emerg Med

View full text Add to dashboard Cite

BackgroundThe growing demand for elderly care often exceeds the ability of emergency department (ED) services to provide quality of care within reasonable time. The purpose of this systematic review is to assess the effectiveness of interventions on reducing ED crowding by older patients, and to identify core characteristics shared by successful interventions.MethodsSix major biomedical databases were searched for (quasi)experimental studies published between January 1990 and March 2017 and assessing the effect of interventions for older patients on ED crowding related outcomes. Two independent reviewers screened and selected studies, assessed risk of bias and extracted data into a standardized form. Data were synthesized around the study setting, design, quality, intervention content, type of outcome and observed effects.ResultsOf the 16 included studies, eight (50%) were randomized controlled trials (RCTs), two (13%) were non-RCTs and six (34%) were controlled before-after (CBA) studies. Thirteen studies (81%) evaluated effects on ED revisits and four studies (25%) evaluated effects on ED throughput time. Thirteen studies (81%) described multicomponent interventions. The rapid assessment and streaming of care for older adults based on time-efficiency goals by dedicated staff in a specific ED unit lead to a statistically significant decrease of ED length of stay (LOS). An ED-based consultant geriatrician showed significant time reduction between patient admission and geriatric review compared to an in-reaching geriatrician.ConclusionInter-study heterogeneity and poor methodological quality hinder drawing firm conclusions on the intervention’s effectiveness in reducing ED crowding by older adults. More evidence-based research is needed using uniform and valid effect measures.Trial registrationThe protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017075575).

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review

Hesselink¹,

Sir

Schoon

2019

BMC Emerg Med

View full text Add to dashboard Cite

show abstract

“…However, the sample may have been biased as there were a large number of potential participants who declined to participate, and those selected for participation may not have been those who were most likely to benefit from a PERS, e.g. those with high baseline levels of anxiety (Lee et al, 2007).…”

Section: Use Of Fall Detectorsmentioning

confidence: 99%

Fall detectors: a review of the literature

Ward

Holliday

Fielden

et al. 2012

Journal of Assistive Technologies

View full text Add to dashboard Cite

show abstract

“…The authors found no evidence that the personal response system reduced anxiety, fear of falls, or health service use (Lee et al, 2007) thereby indicating further research is required to explore how these systems can improve quality of life and engagement with health services.…”

Section: Introductionmentioning

confidence: 96%

Perceptions of falls and falls prevention interventions among Personal Alert Victoria clients

Ayton

Morello

Natora³

et al. 2018

Health Soc Care Community

View full text Add to dashboard Cite

This paper explores the perceptions and experiences of falls among Personal Alert Victoria (PAV) clients and identifies barriers and enablers to engagement in falls prevention interventions. Data were collected via semistructured telephone interviews (n = 12) and a client survey with open-ended and closed-ended questions (n = 46). Descriptive statistics and thematic analysis was guided by the COM-B model (capability, opportunity, and motivation) for behaviour change. The interview and survey explored experiences of falls, falls risk factors, access and participation in falls prevention interventions, access to health and support services, and experiences using the PAV service. Capability barriers identified included poor health, lack of time, low health literacy, and perceived high intensity of exercise classes. Opportunity barriers were lack of transport, high cost, and long waiting times for falls prevention interventions. Motivation barriers were the belief that falls are inevitable and a perceived lack of relevance of falls prevention interventions. Enablers identified were a focus on broader health and well-being benefits (capability), hospitalisations or rehabilitation that incorporates falls prevention in recovery (opportunity), and raising awareness of falls risk (motivation). Findings suggest that further research is required to inform the tailoring of positive health messages to improve the uptake of falls prevention interventions by PAV clients.

show abstract

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 23 publications

References 31 publications

Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review

Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review

Fall detectors: a review of the literature

Perceptions of falls and falls prevention interventions among Personal Alert Victoria clients

Contact Info

Product

Resources

About