Development and preliminary examination of the predictive validity of the Falls Risk Assessment Tool (FRAT) for use in primary care

Nandy, Sudip; Parsons, Suzanne; Cryer, Colin; Underwood, Martin; Rashbrook, Elaine; Carter, Yvonne H; Eldridge, Sandra; Close, Jacqueline C.T.; Skelton, Dawn A.; Taylor, Stephanie; Feder, Gene

doi:10.1093/pubmed/fdh132

Cited by 118 publications

(100 citation statements)

References 24 publications

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“…Falls risk was measured by the Falls Risk Assessment Tool (FRAT). 60 9. Health-related quality of life was measured by the Short Form questionnaire-12 items (SF-12).…”

Section: Ascertainment Of Outcomesmentioning

confidence: 99%

Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care

Iliffe

Kendrick

Morris

et al. 2014

Health Technology Assessment

124

168

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BackgroundRegular physical activity (PA) reduces the risk of falls and hip fractures, and mortality from all causes. However, PA levels are low in the older population and previous intervention studies have demonstrated only modest, short-term improvements.ObjectiveTo evaluate the impact of two exercise promotion programmes on PA in people aged ≥ 65 years.DesignThe ProAct65+ study was a pragmatic, three-arm parallel design, cluster randomised controlled trial of class-based exercise [Falls Management Exercise (FaME) programme], home-based exercise [Otago Exercise Programme (OEP)] and usual care among older people (aged ≥ 65 years) in primary care.SettingForty-three UK-based general practices in London and Nottingham/Derby.ParticipantsA total of 1256 people ≥ 65 years were recruited through their general practices to take part in the trial.InterventionsThe FaME programme and OEP. FaME included weekly classes plus home exercises for 24 weeks and encouraged walking. OEP included home exercises supported by peer mentors (PMs) for 24 weeks, and encouraged walking.Main outcome measuresThe primary outcome was the proportion that reported reaching the recommended PA target of 150 minutes of moderate to vigorous physical activity (MVPA) per week, 12 months after cessation of the intervention. Secondary outcomes included functional assessments of balance and falls risk, the incidence of falls, fear of falling, quality of life, social networks and self-efficacy. An economic evaluation including participant and NHS costs was embedded in the clinical trial.ResultsIn total, 20,507 patients from 43 general practices were invited to participate. Expressions of interest were received from 2752 (13%) and 1256 (6%) consented to join the trial; 387 were allocated to the FaME arm, 411 to the OEP arm and 458 to usual care. Primary outcome data were available at 12 months after the end of the intervention period for 830 (66%) of the study participants.The proportions reporting at least 150 minutes of MVPA per week rose between baseline and 12 months after the intervention from 40% to 49% in the FaME arm, from 41% to 43% in the OEP arm and from 37.5% to 38.0% in the usual-care arm. A significantly higher proportion in the FaME arm than in the usual-care arm reported at least 150 minutes of MVPA per week at 12 months after the intervention [adjusted odds ratio (AOR) 1.78, 95% confidence interval (CI) 1.11 to 2.87;p = 0.02]. There was no significant difference in MVPA between OEP and usual care (AOR 1.17, 95% CI 0.72 to 1.92;p = 0.52). Participants in the FaME arm added around 15 minutes of MVPA per day to their baseline physical activity level. In the 12 months after the close of the intervention phase, there was a statistically significant reduction in falls rate in the FaME arm compared with the usual-care arm (incidence rate ratio 0.74, 95% CI 0.55 to 0.99;p = 0.042). Scores on the Physical Activity Scale for the Elderly showed a small but statistically significant benefit for FaME compared with usual care, as did perceptions of benefits from exercise. Balance confidence was significantly improved at 12 months post intervention in both arms compared with the usual-care arm. There were no statistically significant differences between intervention arms and the usual-care arm in other secondary outcomes, including quality-adjusted life-years. FaME is more expensive than OEP delivered with PMs (£269 vs. £88 per participant in London; £218 vs. £117 in Nottingham). The cost per extra person exercising at, or above, target was £1919.64 in London and £1560.21 in Nottingham (mean £1739.93).ConclusionThe FaME intervention increased self-reported PA levels among community-dwelling older adults 12 months after the intervention, and significantly reduced falls. Both the FaME and OEP interventions appeared to be safe, with no significant differences in adverse reactions between study arms.Trial registrationThis trial is registered as ISRCTN43453770.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 18, No. 49. See the NIHR Journals Library website for further project information.

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“…Falls risk was measured by the Falls Risk Assessment Tool (FRAT). 60 9. Health-related quality of life was measured by the Short Form questionnaire-12 items (SF-12).…”

Section: Ascertainment Of Outcomesmentioning

confidence: 99%

Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care

Iliffe

Kendrick

Morris

et al. 2014

Health Technology Assessment

124

168

View full text Add to dashboard Cite

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“…They include documenting the presence of previous falls, polypharmacy, history of stroke or parkinsonism, and reported balance problems as well as assessing the patient's difficulty getting out of a chair without the use of the arms (the "get up and go" test). 10 A home assessment may result in the removal of small area rugs, the installation of railings and grab bars in washrooms, and the use of special locks and alarms to prevent wandering. Community-based occupational therapists can perform these in-home safety assessments.…”

Section: Patient Assessmentmentioning

confidence: 99%

Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease

Herrmann¹,

Gauthier²

2008

Canadian Medical Association Journal

118

125

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“…Inclusion criteria for the RCT included: age 65 years or older (55+ years for Maori and Pacific Islanders) plus having an increased risk of falling as determined by the falls risk assessment tool questionnaire [15], or having had at least one fall in the past 12 months. All participants passed a mini-mental examination questionnaire and had physician approval to participate in the study.…”

Section: Participantsmentioning

confidence: 99%

Osteoporosis and gait and balance disturbances in older sarcopenic obese New Zealanders

et al. 2009

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Development and preliminary examination of the predictive validity of the Falls Risk Assessment Tool (FRAT) for use in primary care

Abstract: The tool may be useful for identifying people who would benefit from further assessment of their risk of falling and appropriate intervention.

Cited by 118 publications

References 24 publications

Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care

Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care

Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease

Osteoporosis and gait and balance disturbances in older sarcopenic obese New Zealanders

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