Non-pharmacological interventions to prevent falls in older patients: Clinical practice recommendations – the SENATOR ONTOP Series

Rimland, Joseph M.; Abraha, Iosief; Dell'Aquila, Giuseppina; Cruz-Jentoft, Alfonso J.; Soiza, Roy L.; Guðmundsson, Adalsteinn; Petrovic, Mirko; O’Mahony, Denis; Cherubini, Antonio

doi:10.1016/j.eurger.2017.07.013

Cited by 9 publications

(20 citation statements)

References 56 publications

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“…34 Of the 159 records, 144 were excluded, yielding 15 records retained for final analyses and included in the data synthesis. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Table 1 shows the quality assessment characteristics using the AGREE-II tool for the 15 guidelines selected.…”

Section: Resultsmentioning

confidence: 99%

“…12 Accordingly, several medical societies and organizations in different countries have created clinical practice guidelines for fall prevention and management. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] These guidelines are typically based on systematic reviews of the available evidence and consensus by experts in the fields of geriatric medicine, rehabilitation medicine, and physiotherapy, among others. 28,29 Although several of these clinical practice guidelines for fall prevention have been published, little is known about the level of agreement between the recommendations made by them.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults

et al. 2021

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IMPORTANCEWith the global population aging, falls and fall-related injuries are ubiquitous, and several clinical practice guidelines for falls prevention and management for individuals 60 years or older have been developed. A systematic evaluation of the recommendations and agreement level is lacking.OBJECTIVES To perform a systematic review of clinical practice guidelines for falls prevention and management for adults 60 years or older in all settings (eg, community, acute care, and nursing homes), evaluate agreement in recommendations, and identify potential gaps. EVIDENCE REVIEW A systematic review following Preferred Reporting Items for SystematicReviews and Meta-analyses statement methods for clinical practice guidelines on fall prevention and management for older adults was conducted (updated July 1, 2021) using MEDLINE, PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, PEDro, and Epistemonikos databases. Medical Subject Headings search terms were related to falls, clinical practice guidelines, management and prevention, and older adults, with no restrictions on date, language, or setting for inclusion. Three independent reviewers selected records for full-text examination if they followed evidence-and consensus-based processes and assessed the quality of the guidelines using Appraisal of Guidelines for Research & Evaluation II (AGREE-II) criteria. The strength of the recommendations was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation scores, and agreement across topic areas was assessed using the Fleiss κ statistic. FINDINGSOf 11 414 records identified, 159 were fully reviewed and assessed for eligibility, and 15 were included. All 15 selected guidelines had high-quality AGREE-II total scores (mean [SD], 80.1% [5.6%]), although individual quality domain scores for clinical applicability (mean [SD], 63.4% [11.4%]) and stakeholder (clinicians, patients, or caregivers) involvement (mean [SD], 76.3% [9.0%]) were lower. A total of 198 recommendations covering 16 topic areas in 15 guidelines were identified after screening 4767 abstracts that proceeded to 159 full texts. Most (Ն11) guidelines strongly recommended performing risk stratification, assessment tests for gait and balance, fracture and osteoporosis management, multifactorial interventions, medication review, exercise promotion, environment modification, vision and footwear correction, referral to physiotherapy, and cardiovascular interventions. The strengths of the recommendations were inconsistent for vitamin D supplementation, addressing cognitive factors, and falls prevention education. Recommendations on use of hip protectors and digital technology or wearables were often missing. None of the examined guidelines included a patient or caregiver panel in their deliberations.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults

et al. 2021

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“…Therefore, other important outcomes may have been excluded. The standardised method employed in all the ONTOP reviews ensures consistency and has already resulted in published evidence-based recommendations for nondrug management in delirium [34], falls [35,36], stroke [37], pressure sores [38,39], behavioural disturbances in dementia [40], malnutrition [41] and sarcopenia [42]. This method also has the advantage of not pre-specifying interventions in the search terms, allowing evaluation of lesser-known interventions.…”

Section: Discussionmentioning

confidence: 99%

Non-pharmacological, non-surgical interventions for urinary incontinence in older persons: A systematic review of systematic reviews. The SENATOR project ONTOP series

et al. 2020

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Background: Urinary incontinence is especially common in older age. Nonpharmacological therapies are particularly desirable in this group. Objective: To define optimal evidence-based non-pharmacological, non-surgical therapies for urinary incontinence in older persons. Methods: A Delphi process determined critical outcome measures of interest. Studies of any non-pharmacological intervention reporting critical outcomes were identified through database searches for relevant systematic reviews in Medline, Embase, CINAHL, PsycInfo and Cochrane by June 2018. Primary trials with a population mean age ≥65years were identified with subsequent data extraction and risk of bias assessment. Qualitative analysis and meta-analysis, when possible, were undertaken followed by grading of the evidence using GradePro software. Finally, bullet-point recommendations were formulated for the indications and contraindications for non-pharmacological interventions for urinary incontinence in older persons. Results: Frequency of incontinence was identified as a critically important outcome. In total, 33 systematic reviews were identified with 27 primary trials meeting inclusion criteria. Evaluated therapies included exercise therapy, habit retraining, behavioural therapy, electrical stimulation, transcutaneous tibial nerve stimulation, magnetic stimulation, caffeine reduction and acupuncture. From meta-analysis, group exercise therapy and behavioural therapy in women were beneficial in reducing episodes of incontinence (mean reduction of 1.07 (95%CI 0.69-1.45) and 0.74 (95%CI 0.42-1.06) episodes per day respectively, evidence grade 'moderate'). Evidence for other interventions was limited and of insufficient quality. 4 Conclusions: There is sufficient evidence to warrant recommendation of group exercise therapy for stress incontinence and behavioural therapy for urgency, stress or mixed urinary incontinence in older women. Evidence was insufficient to recommend any other non-drug therapy.

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“…Os 13 estudos que integram a amostra final obedecem aos critérios de inclusão e exclusão previamente definidos e possibilitam responder à questão e ao objetivo desta RIL. Os estudos incluídos são predominantemente primários (n=9) (19)(20)(21)(22)(23)(24)(25)(26)(27) e de natureza quantitativa (n=8) (19)(20)(21)(22)(23)(24)(25)27) , com quatro RCT (20,21,25,27) , dois estudos de modelagem (23,24) , um estudo quasi-experimental (22) , um estudo descritivo (19) , quatro estudos são revisões de literatura com metodologia científica (4,9,18,28) e um estudo é qualitativo e metodológico (painel de peritos) (26) .…”

Section: Discussionunclassified

“…Na categoria avaliação do risco ambiental, emerge a recomendação, consensual em todos os estudos, para a avaliação de segurança dentro de portas, de modo a identificar os riscos presentes nas casa do idosos, sobretudo nos que têm alto risco de queda (2,4,26) . A adequação da avaliação do risco conjugada com a implementação das medidas preventivas que o controlam (15) traduzem-se em vantagens econômicas (24) .…”

Section: Discussionunclassified

Intervenção Da Enfermagem Na Prevenção De Queda Em Idoso: Estudo De Revisão

Santos

Baixinho

2020

Cogit. Enferm.

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Objetivo: identificar as intervenções de enfermagem que aumentam a segurança da casa do idoso e previnem a queda.Método: revisão integrativa da literatura orientada pela questão: ‘Que intervenções de enfermagem são adequadas à prevenção de queda no domicílio da pessoa idosa?’. Entre maio e junho de 2018 identificaram-se estudos na EBSCO, B-On, SCOPUS, ISI e JBI.Resultados: os 13 estudos recomendam intervenções que foram organizadas em cincocategorias: avaliação do risco ambiental; aconselhamento sobre modificações; adaptação do espaço e equipamentos; assessoria na aquisição de produtos de apoio; e estratégias cognitivocomportamentais que aumentam a segurança do idoso na utilização do espaço físico da casa.Conclusão: os achados desta revisão permitiram mapear as intervenções que podem ser introduzidas no domicílio do idoso para evitar a queda, a sua recorrência e as lesões associadas

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Non-pharmacological interventions to prevent falls in older patients: Clinical practice recommendations – the SENATOR ONTOP Series

Cited by 9 publications

References 56 publications

Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults

Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults

Non-pharmacological, non-surgical interventions for urinary incontinence in older persons: A systematic review of systematic reviews. The SENATOR project ONTOP series

Intervenção Da Enfermagem Na Prevenção De Queda Em Idoso: Estudo De Revisão

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