[Summary text]
Place of recruitment: Family practice; method of solicitation not reported.
Inclusion criteria: aged 65+, partial or total disability, living alone, unlikely to make contact with a physician.
Number randomised: 103 (Intervention) / 95 (Comparison)
Mean age: 68.5
Sex (% female): 76.0%
Mortality per year in the comparison group: 12.6%
Living alone (%): Not reported
Visitors' professional group: Physician, nurse, other health professionals
Frequency and duration of visits: Not reported
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visitors assessed medical and social needs (including diagnostic and therapeutic medical care), post-hospital follow up, education, counselling, and social service referrals.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 92.2% of intervention participants received one or more home visits over the study period. 30.0% of comparison participants received one or more visits; however, the majority of these visits occurred shortly before the follow-up study was conducted.
Functioning ADL/IADL: Barthal Activities of Daily Living Index (19.5 months)
Health Related QoL: Global Health Status Visual Analog (19.5 months); Quality of Well-Being (19.5 months)
Hospitalisation Admissions: Total number of hospital admissions (19.5 months)
Hospitalisation Days: Total number of days in hospital (19.5 months)
Mortality: Total number of deaths (19.5 months)
Psychiatric Anxiety and Depression: Beck Depression Inventory (19.5 months); Philadelphia Geriatrics Center Morale Scale (20 months)
Location: Northeast, United States
Funding Source: Robert Wood Johnson Foundation
Other notes:
Place of recruitment: Local town practice; method of solicitation not reported.
Inclusion criteria: aged 65+, received home health services or home assistance programmes.
Number randomised: 100 (Intervention) / 100 (Comparison)
Mean age: 81.0
Sex (% female): 70.5%
Mortality per year in the comparison group: 13.0%
Living alone (%): 50.0%
Visitors' professional group: Case managers
Frequency and duration of visits: 6 visits over 12 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved case management and care planning. Visitors assessed physical and cognitive functioning, mood, drug treatments, and the number of home visits by a general practitioner.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): All participants were already receiving home health services or home assistance programmes at baseline. Comparison participants may also have received some home visits.
A&E People: Total number of people admitted to A&E (12 months)
Functioning ADL/IADL: Activities of Daily Living (12 months); Instrumental Activities of Daily Living Items (12 months)
Functioning Cognitive: Short portable mental status questionnaire (12 months)
Hospitalisation Days: Total number of days in hospital (12 months)
Hospitalisation People: Total number of people hospitalised (12 months)
Institutionalisation Days: Total number of days in a nursing home (12 months)
Institutionalisation People: Total number of people admitted to nursing home (12 months)
Mortality: Total number of deaths (12 months)
Psychiatric Anxiety and Depression: Geriatric Depression Scale (12 months)
Location: Rovereto, Italy
Funding Source: Progetto Finalizzato Invecchiamento, National Research Council
Other notes: Estimated cost of intervention was £744 per participant
Place of recruitment: Population registry of municipality; solicited by mail.
Inclusion criteria: aged 70-84, self-reported poor health.
Excluded if: moderate to good health status, received regular home nursing care, or were on waiting list for admission to nursing homes.
Number randomised: 160 (Intervention) / 170 (Comparison)
Mean age: 75.7
Sex (% female): 60.0%
Mortality per year in the comparison group: 6.8%
Living alone (%): 35.0%
Visitors' professional group: Nurses
Frequency and duration of visits: 6.9 visits over 18 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved health assessment and diagnostics. Nurses recorded health problems and provided advice to address them, and they provided follow-up support by phone.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): 77.5% of intervention participants completed all 8 visits. Intervention participants complied with 65.0% of referrals and 58.0% of advice; overall compliance was 61.0%.
A&E Number: Total number of paramedic consultations (18, 24 months)
A&E People: Total number of people receiving paramedic consultations (18, 24 months)
Functioning ADL/IADL: Groningen Activity Restriction Scale A (12, 18, 24 months); Groningen Activity Restriction Scale (12, 18, 24 months)
Functioning Cognitive: Mini Mental State Examination-12 (18 months)
Health Related QoL: RAND-36 Health Change Survey (12, 18, 24 months); Self-rated health (12, 18, 24 months)
Hospitalisation Days: Number of days in hospital per person (18, 24 months)
Hospitalisation People: Total number of people hospitalised (18, 24 months)
Institutionalisation Days: Total number of days in a nursing home (24 months)
Institutionalisation People: Total number of people admitted to nursing home (24 months)
Mortality: Total number of deaths (18, 24 months)
Psychiatric Anxiety and Depression: Medical Outcomes Study 20-item Short Form Survey mental health score (12, 18, 24 months); Geriatric Depression Scale (18 months)
Location: Sittard, Netherlands
Funding Source: Netherlands Organisation for Health Research and Development (ZonMw), The Hague, Netherlands
Other notes: Estimated cost of intervention was €753 per participant
Place of recruitment: Australian Department of Veterans' Affairs; solicited by letter.
Inclusion criteria: aged 70+, lived in 1 of 10 eligible geographical areas, received full entitlements from Department of Veterans' Affairs.
Number randomised: 942 (Intervention) / 627 (Comparison)
Mean age: 77.3
Sex (% female): Not reported
Mortality per year in the comparison group: 3.2%
Living alone (%): Not reported
Visitors' professional group: Nurses, social workers, psychologists, physical therapists
Frequency and duration of visits: 4.5 visits over 36 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved assessment of various physical and mental health problems, as well as environmental hazards. Visitors provided feedback and health materials. The 3 month follow-up included a report to participant's general practitioner.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): Although the checklist was standardised for all visits, visits varied in emphasis because health professionals were asked to apply their professional judgment and skills in determining feedback.
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for Mental Health (24, 36 months) and Physical Health (36 months)
Hospitalisation People: Total number of people hospitalised (36 months)
Institutionalisation People: Total number of people in a nursing home at the completion of the study (36 months)
Mortality: Total number of deaths (36 months)
Location: New South Wales and Queensland, Australia
Funding Source: Australian Dept of Veterans’ Affairs
Other notes:
Place of recruitment: General practices; method of solicitation not reported.
Inclusion criteria: aged 80+, able to move around home, not receiving physiotherapy.
Number randomised: 116 (Intervention) / 117 (Comparison)
Mean age: 83.9
Sex (% female): 100%
Mortality per year in the comparison group: 3.0%
Living alone (%): 77.0%
Visitors' professional group: Physical therapist
Frequency and duration of visits: 4 visits over 12 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visitors prescribed exercises and walking plan. Conducted regular phone calls to maintain motiviation.
Description of comparison: Attention-matched control.
Implementation (fidelity and participant compliance): At 1 year, 42.1% of intervention participants were still completing the programme 3 or more times a week. After 2 years, 43.6% of the remaining intervention participants were still exercising at least 3 times per week.
Falls Number: Total number of falls (12, 24 months)
Falls People: Total number of people who experienced a fall (12 months)
Falls Subjective: Falls Self-Efficacy scale (12 months)
Injuries People: Total number of people experiencing injury due to fall (12 months)
Mortality: Total number of deaths (12, 24 months)
Location: Dunedin, New Zealand
Funding Source: Accident Rehabilitation and Compensation Insurance Corporation of New Zealand and Department of Veterans' Affairs, United States
Other notes:
Place of recruitment: Optometry and opthamology clinics; method of solicitation not reported.
Inclusion criteria: aged 75+, poor "distance visual acuity" in the better eye.
Number randomised: 98 (Intervention) / 96 (Comparison)
Mean age: 83.6
Sex (% female): 66.5%
Mortality per year in the comparison group: 7.3%
Living alone (%): 53.2%
Visitors' professional group: Occupational therapist; physiotherapist
Frequency and duration of visits: 6 visits over 12 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visitors identified and then recommended removal or modification of hazards, provision of new equipment, or making behavioural changes.
Description of comparison: Social visit.
Implementation (fidelity and participant compliance): 66.7% of intervention participants were prescribed an exercise component to their treatment plan. Of these, 89.9% reported complying partially or completely with one or more of the recommendations made by the occupational therapist.
A&E Number: Number of fall-related visits to an A&E department per person (12 months)
Falls Number: Number of falls per person (12 months)
Falls People: Total number of people who experienced a fall (12 months)
Injuries Number: Number of injurious falls per person (12 months)
Mortality: Total number of deaths (12 months)
Location: Dunedin and Auckland, New Zealand
Funding Source: Health Research Council of New Zealand
Other notes: Only two groups from a four-arm trial were used: exercise and home safety (intervention group) and social visit (control).
Estimated cost of intervention was NZ$325 per participant
Place of recruitment: A&E department; solicited by in-person contact at A&E department or telephone the day after discharge.
Inclusion criteria: aged 75+, discharged from the A&E department.
Excluded if: lived outside the immediate area of a local hospital or in a nursing home.
Number randomised: 370 (Intervention) / 369 (Comparison)
Mean age: 82.3
Sex (% female): 60.5%
Mortality per year in the comparison group: 9.6%
Living alone (%): 39.0%
Visitors' professional group: Nurse
Frequency and duration of visits: 2.29 visits on average over 4 weeks
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved health assessment guided by clinical findings, formulation of care plan, urgent medical interventions, and referrals.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported.
A&E Number: Total number of visits to an A&E department (18 months)
A&E People: Total number of people admitted to an A&E department (1, 18 months)
Hospitalisation Admissions: Total number of hospital admissions (1 month)
Institutionalisation People: Total number of people admitted to nursing home (18 months)
Mortality: Total number of deaths (18 months)
Location: Sydney, Austrailia
Funding Source: National Demonstration Hospitals Program of the Commonwealth Department of Health and Aged Care
Other notes:
Place of recruitment: Outpatient medical clinics, aging registry, elderly housing complexes, home health agencies, Meals on Wheels programs, and private clinics; solicited by phone.
Inclusion criteria: aged 64+, unable to descend stairs without holding the railing.
Excluded if: terminally ill, high level of fitness, severe, unstable cardiac disease, severe neurologic disease, complete blindness, lower extremity amputation,high cognitive impairment or lived in a resting home.
Number randomised: 50 (Intervention) / 50 (Comparison)
Mean age: 77.6
Sex (% female): 50.0%
Mortality per year in the comparison group: Not reported
Living alone (%): Not reported
Visitors' professional group: Physical therapist
Frequency and duration of visits: 30 visits over 10 weeks
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: In-home program consisting of resistive lower extremity exercises. Visitors systematically increased resistance for each participant during the 10-week program.
Description of comparison: Wait-list control.
Implementation (fidelity and participant compliance): 86.0% of intervention participants completed the intervention.
No relevant outcome data reported
Location: Durham, North Carolina, U.S.A.
Funding Source: Department of Veterans Affairs, Rehabilitation Research and Development Service, and the Center for the Study of Aging and Human Development, Claude Pepper Center, Duke University
Other notes: Authors did not report post-intervention data on depression, 6-minute walk distance, falls efficacy scale, level of frailty, and SF36-Physical; no response from authors after attempted contact to provide this data.
Place of recruitment: A&E registration database, fracture clinic registry, and local health care providers; solicited by clinician referrals and advertisements in hospitals and health centres.
Inclusion criteria: aged 55+, at risk of falls based on walking speed, previous fracture, or bone strength.
Number randomised: 101 (Intervention) / 100 (Comparison)
Mean age: 71.9
Sex (% female): 94.0%
Mortality per year in the comparison group: 8.0%
Living alone (%): Not reported
Visitors' professional group: Nurse
Frequency and duration of visits: Not reported
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: Yes
Description of intervention: Initial visit included medication review and assessments for functional risk for falls. Follow-up visits included medication review, referral to physio- and occupational therapy, provision of educational materials, and counselling on enactment of falls prevention plan.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): 100% of intervention participants received the intervention. 21.8% of intervention participants and 6.0% of comparison participants were referred to physiotherapy at 6 months. 14.9% of intervention participants and 0.0% of control participants were referred to occupational therapy at 6 months.
Falls People: Total number of individuals reporting falls (6 months)
Hospitalisation People: Total number of people hospitalised (6 months)
Injuries People: Total number of people experiencing injury due to fall (6 months)
Mortality: Total number of deaths (6 months)
Location: Algoma District, Ontario, Canada
Funding Source: Merck Frost Canada Ltd, Sanofi-Aventis Pharmca Inc., Proctor and Gamble Pharmaceuticals Canada, Inc., Eli Lilly Canada Inc., and the Greenshield Foundation
Other notes:
Place of recruitment: Senior service agencies and senior public housing; solicited by in-person visits to service agencies or housing units, phone calls, and mail.
Inclusion criteria: aged 60+, Diagnostic and Statistics Manual IV criteria for minor depression, receiving services from senior service agencies or living in senior service public housing.
Number randomised: 72 (Intervention) / 66 (Comparison)
Mean age: 73.0
Sex (% female): 79.0%
Mortality per year in the comparison group: 3.0%
Living alone (%): 71.7%
Visitors' professional group: Psychotherapist
Frequency and duration of visits: 6.6 vists on average over 19 weeks
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Visitors administered problem-solving treatment for depressive symptoms.
Description of comparison: Usual care, as well as letters sent to participants' physicians and social workers reporting their depression diagnosis with recommendations to continue usual care.
Implementation (fidelity and participant compliance): Not reported.
A&E People: Total number of people who visited an A&E department (6 months)
Hospitalisation People: Total number of people hospitalised (6 months)
Mortality: Total number of deaths (6, 12 months)
Psychiatric Anxiety and Depression: Hopkins Symptom Checklist - Depression (6, 12 months)
Location: Seattle, Washington, U.S.A.
Funding Source: Prevention Research Centers Program of the Centers of Disease Control and Prevention, and University of Washington Health Promotion Research Centre
Other notes: Estimated cost of intervention was US$630 per participant
Place of recruitment: Computerised registration system of the A&E; solicited by letter and telephone.
Inclusion criteria: aged 65+, lived in local community, attended A&E for a fall.
Excluded if: cognitively impaired (Abbreviated Mental Test < 7), had no regular carer, and did not speak English.
Number randomised: 184 (Intervention) / 213 (Comparison)
Mean age: 78.2
Sex (% female): 67.5%
Mortality per year in the comparison group: 12.7%
Living alone (%): 61.2%
Visitors' professional group: Occupational therapist
Frequency and duration of visits: 1 visit after hospital examination
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Physicians led a detailed medical assessment in hospital, followed by an occupational-therapy home-based assessment and education of functionality and environmental hazards. Referral to relevant services and home modifications, if indicated, were also provided.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 152 (83%) medical assessments were undertaken; most were completed within 3 weeks of the index fall. Of the 32 patients who did not attend for assessment, 8 had died, 5 had moved into institutional care, and 19 gave no reason but were willing to complete the follow-up questionnaire. 140 occupational-therapy home assessment were undertaken in the intervention group; 12 patients who had undergone a medical assessment declined the home assessment. These assessments resulted in 67 referrals to hospital outpatient departments, 38 referrals to the day hospital, follow-up by the general practitioner for 33 patients, (16 for drug modification), and a visit to an optician for 27 cases. In only 24 (16%) of the assessments, no further action was required.
Falls Number: Total number of falls (12 months)
Falls People: Number of participants reporting falls (12 months)
Functional ADL/IADL: Barthel index (12 months)
Hospital Admissions: Total number of hospital admissions (12 months)
Injuries People: Number of participants reporting serious injuries from falls (12 months)
Institutionalisation People: Number of people moved to institutional care (12 months)
Mortality: Total number of deaths (12 months)
Location: England
Funding Source: South Thames NHS Research and Development Project Grant
Other notes:
Place of recruitment: Community health centres; method of solicitation not reported.
Inclusion criteria: aged 65+, establishd patient at health centre, income below 200% of the federal poverty level.
Number randomised: 474 (Intervention) / 477 (Comparison)
Mean age: 71.7
Sex (% female): 75.0%
Mortality per year in the comparison group: 3.9%
Living alone (%): 46.8%
Visitors' professional group: Nurse, social worker
Frequency and duration of visits: 13 visits over 24 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visitors provided comprehensive geriatric assessment with development of individualised care plan.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): Not reported
A&E Number: Number of visits to an A&E department per person (12, 24 months)
Functioning ADL/IADL: Assets and Health Dynamics of the Oldest-Old Survey (24 months); Instrumental Activities of Daily Living Items (24 months)
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for (1) Mental Health (24 months) and (2) Physical Health (24 months)
Hospitalisation Admissions: Total number of hospital admissions (12, 24 months)
Hospitalisation Days: Number of days in hospital per person (12, 24 months)
Instituionalisation People: Total number of people admitted to nursing homes (24 months)
Mortality: Total number of deaths (6, 12, 18, 24 months)
Location: Indianapolis, Indiana, U.S.A.
Funding Source: National Institute on Ageing, National Institutes of Health
Other notes: Estimated cost of intervention was US$1000 per participant
Place of recruitment: Participants' homes; solicited by flyer distribution and in-person contact during meal delivery service.
Inclusion criteria: aged 60+, low cognitive impairment, proficiency in English, received home-delivered meals through local community action agency.
Number randomised: 32 (Intervention) / 27 (Comparison)
Mean age: 77.8
Sex (% female): 71.2%
Mortality per year in the comparison group: 25.0%
Living alone (%): Not reported
Visitors' professional group: Nurse
Frequency and duration of visits: 6 visits over 12 weeks
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved establishment of health goals, as well as support and guidance in attaining health goals and accessing local resources.
Description of comparison: Attention-matched control (received health and safety newsletters).
Implementation (fidelity and participant compliance): 56.0% of intervention participants completed all six sessions.
Health Related QoL: Well-Being Picture Scale (3 months); Ryff Psychological Scale (3 months)
Mortality: Total number of deaths (3 months)
Location: Southwest metropolitan area, U.S.A.
Funding Source: National Institutes of Health, National Institute of Nursing Research
Other notes:
Place of recruitment: Primary care practice; solicited by mail.
Inclusion criteria: aged 70+, reported functional impairment, hospital admission in past 6 months.
Excluded if: involved in another research study, had previously been visited by nurse in home.
Number randomised: 73 (Intervention) / 69 (Comparison)
Mean age: 78.6
Sex (% female): 66.9%
Mortality per year in the comparison group: 3.7%
Living alone (%): 39.4%
Visitors' professional group: Nurse
Frequency and duration of visits: 3 visits over 14 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visitors reviewed medical records, medication, and safety and suitability of participants' home environment. Visitors also completed assessment of physical, cognitive, emotional, and social functioning, and they developed care plans with primary care physician, patient, family, caregivers, and other healthcare professionals.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
A&E Number: Total number of visits to an A&E department (14 months)
Hospitalisations Admissions: Total number of hospital admissions (14 months)
Hospitalisation Days: Total number of days in hospital (14 months)
Institutionalisation People: Total number of people admitted to nursing homes (14 months)
Mortality: Total number of deaths (14 months)
Location: Stoney Creek, Ontario, Canada
Funding Source: Ontario Ministry of Health, Community Health Branch
Other notes:
Place of recruitment: A&E department in a university teaching hospital; solicited by postal questionnaire and telephone.
Inclusion criteria: aged 65+, presented to A&E with a fall or fall-related injury, sustained at least one additional fall in the preceding year.
Excluded if: cognitively impaired, had at least 1 previous episode of fainting, immobile, lived more than 15 miles from hospital, registered blind, aphasic, had a clear medical explanation for their fall (e.g., stroke), enrolled in another study.
Number randomised: 159 (Intervention) / 154 (Comparison)
Mean age: 77.0
Sex (% female): 72.2%
Mortality per year in the comparison group: 3.2%
Living alone (%): Not reported
Visitors' professional group: Occupational therapist, physiotherapist
Frequency and duration of visits: Not reported
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: Yes
Description of intervention: Programme began with a hospital-based medical assessment of fall history and full medical examination. Visits involved home-based physiotherapy and a occupational therapy assessment of home environmental hazards, followed by a prioritised individualised intervention for fall risk factors.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 91.8% of intervention participants underwent a full risk factor assessment. Intervention participants attended hospital a median of 2 occasions (range 0–10) for stabilisation of risk factors, received a median of 2 physiotherapy intervention visits (range 0–16), and 1 occupational therapy visit (range 0–4) with a median follow-up time of 32 days (range 0–143). 21.4% of the comparison participants received some form of specialist falls intervention during follow-up.
A&E People: Total number of people admitted to an A&E department due to fall (12 months)
Falls Number: Total number of falls (12 months)
Falls People: Total number of people who experienced a fall (12 months)
Falls Subjective: Activities-specific Balance Confidence Scale (12 months)
Functioning Cognitive: Mini-Mental State Examination (12 months)
Hospitalisation Days: Total number of days in hospital (12 months)
Hospitalisation People: Total number of people admitted to hospital due to fall (12 months)
Injuries People: Total number of people who experienced a fracture (12 months)
Mortality: Total number of deaths (12 months)
Location: Newcastle upon Tyne, North Tyneside, and Gateshead; U.K.
Funding Source: Wellcome Trust and Northern, and Yorkshire NHS Executive
Other notes:
Place of recruitment: Primary care practices; solicited by mail.
Inclusion criteria: aged 75+ (or aged 55+ if Maori), had fallen in the previous 12 months.
Excluded if: unable to understand study information and consent processes, unstable or progressive medical condition, severe physical disability, dementia.
Number randomised: 155 (Intervention) / 157 (Comparison)
Mean age: 80.8
Sex (% female): 68.9%
Mortality per year in the comparison group: 2.6%
Living alone (%): Not reported
Visitors' professional group: Nurse
Frequency and duration of visits: Frequency not reported, duration of 12 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved health and falls risk assessment. Visitors referral of participants to physicians, optomotrists, podiatrists, and other health professionals.
Description of comparison: Usual care from general practitioner. Also offer at least two social visits and a written falls prevention pamphlet.
Implementation (fidelity and participant compliance): 24.4% of referred intervention participants reported undertaking three exercise sessions per week 10 months after the programme concluded.
Falls Number: Total number of falls (12 months)
Falls People: Total number of people who experienced at least 1 fall (12 months)
Injuries Number: Total number of moderate injurious falls (12 months)
Mortality: Total number of deaths (12 months)
Location: Hutt Valley, New Zealand
Funding Source: Accident Compensation Corporation, the Hutt Valley District Health Board, the Lotteries Commission, and the Wellington Medical Research Foundation
Other notes:
Place of recruitment: Directories of veterans groups and voter registries; solicited by mail.
Inclusion criteria: aged 70+, veteran of US armed services, not enrolled in Veterans Affairs outpatient clinic.
Excluded if: suffering from dementia or known terminal disease.
Number randomised: 131 (Intervention) / 123 (Comparison)
Mean age: 72.7
Sex (% female): 2.3%
Mortality per year in the comparison group: 3.3%
Living alone (%): 20.1%
Visitors' professional group: Physician’s assistant or nurse, volunteer home visitors
Frequency and duration of visits: 4 visits over 12 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved home safety inspection, health education, physical and mental health assessments, medication review, and other geriatric screenings. Follow-ups included sharing of assessment results with physician, a letter detailing recommendations for each participant, and additional visits to assist with compliance with recommendations.
Description of comparison: Usual care, with follow-up phone interviews.
Implementation (fidelity and participant compliance): Staff members accompanied volunteers on 2+ visits to ensure fidelity. 53.0% of intervention participants complied with all recommendations, 42.0% complied with at least one (but not all), and 5.0% complied with none.
Falls People: Total number of people who experienced a fall (12 months)
Functioning ADL/IADL: Activities of Daily Living (12 months); Instrumental Activities of Daily Living (12 months)
Hospitalisation People: Total number of people hospitalised (12 months)
Institutionalisation Days: Total number of days in a nursing home (12 months)
Institutionalisation People: Total number of people admitted to nursing home (12 months)
Mortality: Total number of deaths (12 months)
Location: San Fernando Valley, Los Angeles, U.S.A.
Funding Source: Disabled American Veterans Charities of Greater Los Angeles and the Disabled American Veterans California Rehabilitation Foundation, Inc.
Other notes:
Place of recruitment: Capital Regional District of Victoria, British Columbia; solicited by community advertising campaign.
Inclusion criteria: aged 60+, sustained a fall within previous 6 months, lived in Capital Regional District.
Number randomised: 50 (Intervention) / 50 (Comparison)
Mean age: 74.6
Sex (% female): 80.0%
Mortality per year in the comparison group: 0.0%
Living alone (%): Not reported
Visitors' professional group: Nurse
Frequency and duration of visits: 3 visits over 6 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved comprehensive personal and home risk profile, comprehensive falls assessment risk, counselling session, booklet, and video.
Description of comparison: Not reported.
Implementation (fidelity and participant compliance): Not reported.
Falls Number: Number of falls per person (6 months)
Falls Subjective: Fear of falling (6 months); Falls self-efficacy (6 months)
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 (6 months)
Mortality: Total number of deaths (6 months)
Location: Victoria, British Columbia, Canada
Funding Source: Not reported
Other notes:
Place of recruitment: Local social service agencies and an area agency on aging; solicited by in-person contact at agencies and media announcements in the Philadelphia region.
Inclusion criteria: aged 70+, low cognitive impairment, receiving home or occupational therapy, functionally vulnerable, ambulatory, English speaking
Number randomised: 160 (Intervention) / 159 (Comparison)
Mean age: 79.0
Sex (% female): 81.8%
Mortality per year in the comparison group: 6.6%
Living alone (%): 61.8%
Visitors' professional group: Occupational therapist, physical therapist
Frequency and duration of visits: 6 visits over 12 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved environmental modification, behavioural and cognitive strategies, and exercises for fall prevention led by physical therapist. Follow-ups involved phone calls to reinforce strategy.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
Falls Subjective: Falls self-efficacy (6 months); Overall functional efficacy (6 months)
Functioning ADL/IADL: Activities of Daily Living (6 months); Mobility items (6 months); Instrumental Activities of Daily Living (6 months)
Mortality: Total number of deaths (12, 24, 48 months)
Location: Philadelphia area, Pennsylvania, U.S.A.
Funding Source: National Institute on Aging
Other notes: Estimated cost of intervention was US$1222 per participant
Place of recruitment: Hospital and community therapy stroke registers; method of solicitation not reported
Inclusion criteria: aged 50+, had a stroke at least 1 year previously and associated mobility problems
Excluded if: "non-stroke caused" mobility problems, dementia, severe comorbidity, bedfast, undergone physiotherapy treatment within past 6 months
Number randomised: 85 (Intervention) / 85 (Comparison)
Mean age: 72.5
Sex (% female): 44.0%
Mortality per year in the comparison group: 7.8%
Living alone (%): 27.5%
Visitors' professional group: Physical therapist
Frequency and duration of visits: 3 visits on average over 3 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved physiological assessment followed by a physiotherapy problem solving approach.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): The median number of treatments per intervention participant was 3 (inter-quartile range: 2–7, range: 0–22).
The mean duration of every treatment for intervention participants was 44 min (SD: 21, range: 10–90).
Falls People: Total number of people who experienced a fall (3, 9 months)
Mortality: Total number of deaths (9 months)
Location: U.K.
Funding Source: Stroke Association, Hospital Savings Association
Other notes:
Place of recruitment: national registry; method of solicitation not reported
Inclusion criteria: aged 70+, not currently living in nursing home
Number randomised: 1844 (Intervention) / 1899 (Comparison)
Mean age: Not reported
Sex (% female): 58.5%
Mortality per year in the comparison group: 4.7%
Living alone (%): Not reported
Visitors' professional group: Nurse
Frequency and duration of visits: Varied over 5 years
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Social medical intervention that involved introduction to services, advice to the aged and associated personnel, coordination and follow-up for assessment of results.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): Did not report.
Institutionalisation, People: Total number of people admitted to nursing homes (12, 28 and 60 months)
Mortality: Total number of deaths (60 months)
Location:Odense, Denmark
Funding Source: Odense’s third magistral department. Sygekassernes Helsefond (No. 9665) and Statens samfundsvidenskabeligeforskningsrgd (J.nr. 514-10161
Other notes:
Place of recruitment: Official registers from two urban districts; solicitation method not reported.
Inclusion criteria: Aged 80+, community dwelling, not be dependent on municipal home help service or care, be independent from another person in ADLs, frail, and be cognitively intact (MMSE ≥ 25).
Number randomised: 174 (Intervention) / 114 (Comparison)
Mean age: 86.0
Sex (% female): 62.8%
Mortality per year in the comparison group: 0%
Living alone (%): 53.5%
Visitors' professional group: Occupational therapist, physiotherapist, registered nurse, or social worker
Frequency and duration of visits: 1 visit lasting 1.5-2 hours
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Educational information about relevant services in the community for senior citizens, identification of and advice for environmental fall risk factors in the home, and exercise advice and instruction.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): All participants assigned to a preventive home visit received the intervention. No adverse events were reported, and no known organized co-intervention took place during the period in question.
Functional ADL/IADL: The ADL Staircase (3 months)
Health-Related QoL: Self-rated health (3 months)
Mortality: Total number of deaths (3 months)
Location: Gothenburg, Sweden
Funding Source: Vardalinstitutet, the Swedish Institute for Health Sciences, the Research and Development Council of the County of Sodra Alvsborg, and the SwedBank Sjuharads Foundation for Research at the Hospital of Sodra Alvsborg.
Other notes:
Place of recruitment: At-home long term care programme; method of solicitation not reported
Inclusion criteria: aged 65+, recommended for personal care
Number randomised: 81 (Intervention) / 86 (Comparison)
Mean age: 78.0
Sex (% female): 78.4%
Mortality per year in the comparison group: 7.0%
Living alone (%): 75.5%
Visitors' professional group: Nurse
Frequency and duration of visits: Varied frequency over 36 months
Fall prevention: No
Included exercise: Yes
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved development of personal health plan, with nurse support, reinforcement and referrals.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): Not reported.
Institutionalisation People: Total number of people admitted to nursing home (12, 24, 36 months)
Mortality: Total number of deaths (12, 24, 36 months)
Location: New Westminster, British Columbia, Canada
Funding Source: British Columbia Health Research Foundation
Other notes:
Place of recruitment: List of patients in Quebec Health Insurance Plan; solicited by mail
Inclusion criteria: aged 75+, at risk of functional decline
Number randomised: 250 (Intervention) / 253 (Comparison)
Mean age: 80.3
Sex (% female): 64.2%
Mortality per year in the comparison group: 7.1%
Living alone (%): Not reported
Visitors' professional group: Nurse
Frequency and duration of visits: 1 visit over 12 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved medical and psychiatric evaluation, recommendations to general practitioner, and direct referrals to specialists
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 66.8% of intervention participants complied with recommendations.
Functioning ADL/IADL: Functional Autonomy Measurement System (SMAF) (12 months)
Health Related QoL: Dupuy General Well-Being (12 months)
Institutionalisation People: Total number of people admitted to nursing home (12 months)
Mortality: Total number of deaths (12 months)
Location: Sherbrooke City, Quebec, Canada
Funding Source: Quebec Health Research Fund
Other notes:
Place of recruitment: A&E and General Practice Cooperative that provided after-hours emergency care; solicited by in-person contact when presenting for fall.
Inclusion criteria: aged 65+.
Excluded if: non-Dutch speaking, cognitively impaired, had been admitted for more than 4 weeks to a hospital or another institution, permanently wheelchair-dependent or bedridden.
Number randomised: 166 (Intervention) / 167 (Comparison)
Mean age: 74.9
Sex (% female): 68.5%
Mortality per year in the comparison group: 0.6%
Living alone (%): Not Reported
Visitors' professional group: Medical professionals (geriatricians, GPs, rehabilitation physicians), geriatric nurses, occupational therapists
Frequency and duration of visits: 1 visit over 1 month
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Programme began with hospital-based medical assessment comprising a comprehensive general examination of potential risk factors for new falls. An occupational therapist then visited the participants at home for a structured functional and environmental assessment. Technical aids and adaptations or additional support were directly referred to and delivered by social and community services.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
Falls People: Total number of people who experienced a fall (4, 12 months)
Falls Subjective: Fear of falling (4, 12 months)
Functioning ADL/IADL: Frenchay Activity Index (4, 12 months); Groningen Activity Restriction Scale (4, 12 months)
Health Related QoL: Euroqol perceived health (4, 12 months); Medical Outcomes Study Short Form Health Survey-36 items for perceived health (4, 12 months)
Injuries People: Total number of people experiencing injury due to fall (4, 12 months)
Mortality: Total number of deaths (12 months)
Psychiatric Anxiety and Depression: Hospital Anxiety and Depression Scale (12 months)
Location: University Hospital Maastricht, Netherlands
Funding Source: Netherlands Organization for Health Research and Development Grant 945-02-053
Other notes:
Place of recruitment: location of recruitment not reported; method of solicitation not reported
Inclusion criteria: aged 65+, competent to give consent, fallen within the previous 3 months, ambulatory
Excluded if: fall occurred (1) during high risk activities, (2) while in a treatment hospital, (3) as a result of a syncope or acute stroke, (4) and resulted in lower extremity fracture.
Number randomised: 79 (Intervention) / 84 (Comparison)
Mean age: 77.7
Sex (% female): 71.8%
Mortality per year in the comparison group: 6.0%
Living alone (%): Not reported
Visitors' professional group: Nurse, occupational therapist, physical therapist, or geriatric medicine specialist
Frequency and duration of visits: 2 visits over 12 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visits included evaluation of participant and environmental risk, design of plan to reduce falls risk, recommendations for enacting plan and referrals, and instruction for a home exercise program.
Description of comparison: Attention-matched control
Implementation (fidelity and participant compliance): Intervention participants adhered to 81.1% of recommendations.
A&E People: Total number of people admitted to an A&E department due to fall (12 months)
Falls Number: Number of falls per person (12 months)
Falls People: Total number of people who experienced a fall (12 months)
Hospitalisation People: Total number of people hospitalised due to fall (12 months)
Injuries People: Total number of people who experienced a fall-related fracture (12 months)
Institutionalisation People: Total number of people admitted to nursing home (12 months)
Mortality: Total number of deaths (12 months)
Location: Calgary, Canada
Funding Source: Health Services Research and Innovation Fund of the Alberta Heritage Foundation for Medical Research
Other notes:
Place of recruitment: General and community hospitals: method of solicitation not reported
Inclusion criteria: aged 80+, prescribed two or more drugs on discharge, admitted as emergency and discharged to home
Excluded if: received dialysis, participated in intensive discharge service
Number randomised: 437 (Intervention) / 435 (Comparison)
Mean age: 85.4
Sex (% female): 62.5%
Mortality per year in the comparison group: 29.0%
Living alone (%): 62.1%
Visitors' professional group: Pharmacist
Frequency and duration of visits: 2 visits over 6 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved assessment of self-medication and drug adherence, patient and carer medication education, removal of out of date drugs, report of possible interactions, and recommendations of compliance aids. Follow-up visit to reinforce original advice.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 84.4% of intervention participants received first visits. More than 90% of first visits occurred within two weeks of recruitment (mean 7.2 days), and visits lasted a mean (SD) of 61 (23) minutes. 69.2% of intervention participants received second visits, which took a mean (SD) of 42 (19) minutes. Visits generated a total of 933 recommendations or comments to general practitioners (2.58 recommendations on average per visited participant).
A&E Number : Total number of admissions to an A&E department (6 months)
Health Related QoL: Euroqol Visual Analogue Scale (3, 6 months); Euroqol-5 Dimensions health status questionnaire (3, 6 months)
Institutionalisation People: Total number of people admitted to nursing or residential home (6 months)
Mortality: Total number of deaths (6 months)
Location: Norfolk and Suffolk, U.K.
Funding Source: NHS Eastern Region R&D and the Academic Pharmacy Practice Unit of the University of East Anglia
Other notes: Estimated cost of intervention was £144 per participant
Place of recruitment: location of recruitment not reported; method of solicitation not reported
Inclusion criteria: aged 65+
Number randomised: 60 (Intervention) / 60 (Comparison)
Mean age: 72.0
Sex (% female): 45.8%
Mortality per year in the comparison group: Not reported
Living alone (%): Not reported
Visitors' professional group: Community health professional
Frequency and duration of visits: 2 visits over 4 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visitors assessed medical, psychosocial, and environmental falls risk factors. They also provided a falls checklist and an individualised brochure tailored to each participant based on assessment.
Description of comparison: Standardized fall-prevention information.
Implementation (fidelity and participant compliance): Not reported.
Falls People: Total number of people who experienced a fall (4 months)
Falls Subjective: Falls self-efficacy (4 months)
Location: Hsin-Chu County, northwest Taiwan
Funding Source: Not reported
Other notes:
Place of recruitment: A&E department case records; method of solicitation not reported
Inclusion criteria: aged 65-79, female, case reference to "fall"
Excluded if: admitted to hospital or institutional care
Number randomised: 60 (Intervention) / 49 (Comparison)
Mean age: 71.9
Sex (% female): 100%
Mortality per year in the comparison group: Not reported
Living alone (%): Not reported
Visitors' professional group: Health professional
Frequency and duration of visits: 1 visit over 12 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visitors provided advice for pain control and medication, how to get up after a fall, falls risk factors, diet, and exercise. Visits also included referrals to other health services.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for General Health (3 months); Mental Health (3 months); Physical Health (3 months)
Location: North Staffordshire, U.K.
Funding Source: Not reported
Other notes:
Place of recruitment: location of recruitment not reported; method of solicitation not reported
Inclusion criteria: aged 65+, able to walk only with assistance, went outdoors less than 3 times a week
Number randomised: 59 (Intervention) / 60 (Comparison)
Mean age: 82.7
Sex (% female): 47.0%
Mortality per year in the comparison group: 6.7%
Living alone (%): Not reported
Visitors' professional group: Public health nurses
Frequency and duration of visits: 4.3 visits on average over 18 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits included comprehensive in-home assessments, specific care recommendations, and the offering of care services if needed.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
Falls Subjective: Falls self-efficacy (18 months)
Functioning ADL/IADL: Barthal Activities of Daily Living Index (18 months); TMIG Index of Competence (18 months)
Hospitalisation People: Total number of people hospitalised (18 months)
Institutionalisation People: Total number of people admitted to nursing home (18 months)
Mortality: Total number of deaths (18 months)
Psychiatric Anxiety and Depression: Geriatric Depression Scale (18 months)
Location: Saku City, Japan
Funding Source: Japan Ministry of Health, Labour Welfare, Kimura Foundation for Nursing Education, Mitsubishi Foundation, and Pfizer Health Research Foundation
Other notes:
Place of recruitment: Long-Term Care Insurance Registries; solicited via mail.
Inclusion criteria: Aged 65+, ambulatory, living at home, and not having utilised formal long-term care services for the past 3 months, and frail.
Number randomised: 161 (Intervention) / 162 (Comparison)
Mean age: 79.9
Sex (% female): 74.0%
Mortality per year in the comparison group: 6.2%
Living alone (%): 27.9%
Visitors' professional group: Nurses, Care Managers, or Social Workers
Frequency and duration of visits: Visits every 6 months for 2 years (4 visits total)
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits included structured multidimensional interview-based assessments of five key elements: locomotion, daily activities, social contacts or relationships with other people, health conditions, and signs of abuse.
Description of comparison: No treatment
Implementation (fidelity and participant compliance): See Table 3. For the majority of participants, all four visits were implemented (first visit: 87%, second: 85.7%, third: 83.9%, fourth 83.9%). A total of 13 additional home visits between the routine home visits were provided to 11 elders in the intervention group.
Funcational ADLs/IADLs: Barthel Index (24 months); Tokyo Metropolitan Institute of Gerontology Index of Competence (24 months)
Institutionalisation People: Total number of people institutionalised (24 months)
Mortality: Total number of deaths (24 months)
Psychiatric Anxiety and Depression: Geriatric Depression Scale – Japanese translation (24 months)
Location: Izumiotsu, Sennan, and Misaki, in Osaka, Japan
Funding Source: Japan Society for the Promotion of Science
Other notes:
Place of recruitment: Community agencies, senior centres, and senior housing sites; solicited by mail, telephone, and clinician referrals
Inclusion criteria: aged 60+, reported one or more functional limitations, had no medical history hindering exercise, were not receiving rehabilitation services, ambulatory with or without assistive devices, willingness to participate
Number randomised: 54 (Intervention) / 66 (Comparison)
Mean age: 74.3
Sex (% female): 74.2%
Mortality per year in the comparison group: Not reported
Living alone (%): Did not report
Visitors' professional group: Physical therapist
Frequency and duration of visits: 2 visits over 6 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved guidance during a 35-minute videotape programme of 11 limb-strengthing, resistance-based exercises.
Description of comparison: No-exercise treatment as usual
Implementation (fidelity and participant compliance): Providers made average of 7.5 supplemental telephone contacts per intervention participant during the 6 months for assisting with intervention. 77.8% of intervention participants adhered to the recommended exercise frequency and level of resistance.
No relevant outcome data reported
Location: Boston, Massachusetts, U.S.A.
Funding Source: National Institutes of Health
Other notes:
Place of recruitment: General Practice; solicited by mail and telephone.
Inclusion criteria: aged 80+, prescribed 4+ daily oral medications, and at least one of the following: living alone, confused mental state, vision or hearing impairment, medication-related morbidity, or 7+ regular oral medicines.
Excluded if: used adherence aid.
Number randomised: 68 (Intervention) / 66 (Comparison)
Mean age: 84.3
Sex (% female): 65.7%
Mortality per year in the comparison group: 17.9%
Living alone (%): Not reported
Visitors' professional group: Community pharmacist
Frequency and duration of visits: 2 visits over 6-8 weeks
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Initial visit included patient education, removal of out-of-date drugs, assessment for adherence aid. Single follow-up visit was 6-8 weeks later to reinforce treatment plan and assess need for additional changes. Pharmacist and general practitioner also met to discuss medication changes.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 94.2% of intervention participants received the intervention.
Health Related QoL: EQ-5d (6 months); Visual Analogue Scale (6 months)
Hospitalisation Admissions: Total number of hospital admissions (6 months)
Institutionalisation People: Total number of people admitted to nursing home (6 months)
Mortality: Total number of deaths (6 months)
Location: Norwich District, U.K.
Funding Source: NHS Executive Eastern Region research funding
Other notes: Estimated cost of intervention was £122 per participant
Place of recruitment: A&E; Solicitation method not reported.
Inclusion criteria: aged 65+ years, attending A&E with a fall.
Excluded if: admitted to hospital as a result of the Index fall, lived in institutional care, or were out of the area.
Number randomised: 171 (Intervention) / 177 (Comparison)
Mean age: Median 75 (IQR 70-81)
Sex (% female): 74.4%
Mortality per year in the comparison group: 8.0%
Living alone (%): 44.0%
Visitors' professional group: Nurse
Frequency and duration of visits: 1 visit
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: The intervention group was assessed for risk factors for falls at home by the falls nurse 2–4 weeks following the Index fall. Medical, functional, and environmental items were assessed. Participants were then given advice and education about safety in the home, and simple modifications were made with consent.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 99.4% of intervention participants received the home visit.
A&E People: Total number of people presenting to A&E (6 months)
Falls Number: Total number of falls (6 months)
Falls People: Total number of people who experienced a fall (6 months)
Functioning ADL/IADL: Barthal index (6 months)
Hospital Admissions: Total number of falls-related hospital admissions (6 months)
Hospital Days: Total number of days spent in hospital beds (6 months)
Mortality: Total number of deaths (6 months)
Location: Liverpool, UK
Funding Source: North West Region NHS Executive; Liverpool and Wirral Research and Development Liaison Group
Other notes:
Place of recruitment: Clinics and hospitals; method of solicitation not reported.
Inclusion criteria: aged 65+, required medical attention due to sustaining a fall in the previous 4 weeks.
Number randomised: 50 (Intervention) / 50 (Comparison)
Mean age: 76.8
Sex (% female): 51.0%
Mortality per year in the comparison group: 0.0%
Living alone (%): 34.0.%
Visitors' professional group: Physical therapist
Frequency and duration of visits: 8 visits over 4 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visitors provided individualised physiological training consisting of stretching, muscle strengthening, and balance training at increasing levels of difficulty.
Description of comparison: Attention-matched control, with education group receiving social visits and pamphlets on fall prevention
Implementation (fidelity and participant compliance): Not reported
Falls People: Total number of people who experienced a fall (8 months)
Falls Subjective: Fear of falling (6, 8 months)
Functioning ADL/IADL: Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire (6, 8 months)
Health Related QoL: World Health Organisation Quality of Life Instrument Environmental (6, 8 months); Physical (6, 8 months); Psychological (6, 8 months); and Social scales (6, 8 months)
Mortality: Total number of deaths (6, 8 months)
Psychiatric Anxiety and Depression: Geriatric Depression Scale (6, 8 months)
Location: Shin-Sher township, Taiwan
Funding Source: The Bureau of Health Promotion, Department of Health, and the National Science Council, Taiwan
Other notes:
Place of recruitment: Referral-based falls clinics; solicited by in-person contact at falls clinic
Inclusion criteria: aged 70+, community dwelling, could walk 3 meters, and at least one of the following: one additional fall not related to fainting in the previous year, completion of walking task, low physiological impairment.
Excluded if: progressive neurological condition, life expectancy of less than 12 months, high cognitive impairment.
Number randomised: 31 (Intervention) / 28 (Comparison)
Mean age: 82.2
Sex (% female): 69.5%
Mortality per year in the comparison group: 10.5%
Living alone (%): Not reported
Visitors' professional group: Physiotherapists
Frequency and duration of visits: 5 visits over 6 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Programme consisted of home-based balance and strength retraining routine. Physiotherapists prescribed a selection of exercises at the first visit, and returned every other week three additional times to make progressive adjustments to the protocol. Physiotherapists provided participants an exercise manual and encouraged them to perform the exercise programme three times per week and to walk at least twice per week. Physiotherapists made a final visit at 6 months to check and encourage continued adherence.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): 25.0% of intervention participants completed the programme 3 times per week or more, 58.3% completed the programme 2 times per week or more, and 66.7% completed the programme at least once per week.
Falls People: Total number of people who experienced a fall (12 months)
Falls Subjective: Psychsiological Profile Assessment Z-score (6 months)
Functioning ADL/IADL: Timed up and go test (6 months)
Functioning Cognitive: Verbal Digits Backwards Test (6 months); Stroop Color-Word Test (6 months); Trail Making Test Part B (6 months)
Mortality: Total number of deaths (6 months)
Location: Vancouver, British Columbia, Canada
Funding Source: Canadian Institutes of Health Research
Other notes:
Place of recruitment: General Practice; solicited by mail
Inclusion criteria: aged 70+, no mental impairment, female, living alone
Number randomised: Appx 60 (Intervention) / Appx 60 (Comparison)
Mean age: Not reported
Sex (% female): 100%
Mortality per year in the comparison group: Not reported
Living alone (%): 100%
Visitors' professional group: Health rofessional
Frequency and duration of visits: 4 visits over 4 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Visitors identified participants' potential and actual health problems and then developed a plan of action tailored to discovered problems.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
No relevant outcome data reported
Location: Scotland
Funding Source: Scottish Home and Health Department
Other notes:
Place of recruitment: City registry; solicited by mail
Inclusion criteria: aged 85+ and at least one of the following: poor cognition, 2 or more falls during preceding year, frequent feelings of loneliness, poor self-rated health, poor visual acuity, poor hearing, depression, impaired balance
Number randomised: 243 (Intervention) / 243 (Comparison)
Mean age: 88.0
Sex (% female): 79.0%
Mortality per year in the comparison group: 15.4%
Living alone (%): Not reported
Visitors' professional group: Occupational therapist, physical therapist
Frequency and duration of visits: 3 visits on average over 3 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved a physiological assessment and physiotherapy treatment with a problem solving approach at home or in out-patient rehabilitation centre.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
A&E People: Total number of people seeking first aid in hospital (16 months)
Falls Number: Total number of falls (16 months)
Falls People: Total number of people who experienced a fall (16 months)
Functioning ADL/IADL: Severe restriction (16 months)
Functioning Cognitive: Mini-Mental State Examination (16 months)
Health Related QoL: Poor self-related health (16 months)
Injuries Number: Number of injurious falls per person (16 months)
Injuries People: Total number of people experiencing injury due to fall (16 months)
Mortality: Total number of deaths (16 months)
Psychiatric Anxiety and Depression: Geriatric Depression Scale (16 months)
Location: Oulu, Finland
Funding Source: Ministry of Health and Social Affairs of Finland
Other notes:
Place of recruitment: Community Care Access Centre registry; method of solicitation not reported.
Inclusion criteria: aged 75+, require assistance with personal care.
Excluded if: refused to give informed consent, poor cognitive or physical functioning, deemed eligible for nursing services, unable to understand English.
Number randomised: 144 (Intervention) / 144 (Comparison)
Mean age: 83.8
Sex (% female): 76.9%
Mortality per year in the comparison group: Not reported
Living alone (%): Not reported
Visitors' professional group: Registered nurse
Frequency and duration of visits: Median of 5 visits over 6 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Vistis involved usual care plus a proactive nursing health promotion intervention that included an initial health assessment, health education, identification of risk factors for functional decline, and bolstering of environmental support.
Description of comparison: Usual home care services
Implementation (fidelity and participant compliance): 84.7 % of intervention participants received the intervention.
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for Mental Health (6 months) and Physical Health (6 months)
Psychiatric Anxiety and Depression: Center for Epidemiologic Studies Depression Scale (CES - D) (6 months)
Location: Ontario, Canada
Funding Source: Canadian Health Services Research Foundation, Ontario Ministry of Health and Long-term Care, Community Care Access Centre of Halton, McMaster University, System-linked Research Unit on Health & Social Services Utilisation
Other notes:
Place of recruitment: Community Care Access Centre registry; method of solicitation not reported.
Inclusion criteria: aged 75+, low cognitive impairment, at risk for falls, required assistance for personal care, competent in English or with a translator available.
Number randomised: 55 (Intervention) / 54 (Comparison)
Mean age: Not reported
Sex (% female): 71.7%
Mortality per year in the comparison group: 14.5%
Living alone (%): 43.0%
Visitors' professional group: Case manager, registered nurse, occupational therapist, physiotherapist, registered dietitian
Frequency and duration of visits: Minimum of 6 visits over 6 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved assessment of known risk factors for falls and other factors influencing health, management of modifiable fall risk factors, and support and education about falls prevention.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 100% of intervention participants received the intervention.
Falls Number: Number of falls per person (6 months)
Falls Subjective: Modified Falls Efficacy Scale (6 months)
Functioning Cognitive: Short Mini-Mental State Examination (6 months)
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for Mental Health (6 months) and Physical Health (6 months)
Hospitalisation Days: Number of acute hospital days for fall per person (6 months)
Mortality: Total number of deaths (6 months)
Psychiatric Anxiety and Depression: Center for Epidemiologic Studies Depression Scale (CES - D) (6 months)
Location: Ontario, Canada
Funding Source: Canadian Patient Safety Institute (CPSI – Grant Number RFAAA0506164), Community Care Access Centre of Halton, McMaster University System-Linked Research Unit on Health and Social Services Utilization, and Ontario Ministry of Health and Long-Term Care
Other notes:
Place of recruitment: General Practice; method of solicitation not reported.
Inclusion criteria: aged 75+, registered with the General Practice in 1986
Excluded if: "too ill" or in hospital
Number randomised: 151 (Intervention) / 145 (Comparison)
Mean age: Not reported
Sex (% female): Not reported
Mortality per year in the comparison group: 9.5%
Living alone (%): Not reported
Visitors' professional group: Registered nurse
Frequency and duration of visits: 1 visit over 20 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved special medical screening and assessment, health information provision, and referals and/or advice based on assessment results.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
Hospitalisation People: Total number of people in hospital or too ill to be contacted at end of study (20 months)
Mortality: Total number of deaths (20 months)
Location: Newcastle, England
Funding Source: Newcastle Health Authority
Other notes:
Place of recruitment: greater Boston area; solicited by newspaper and radio advertisements, and community presentations.
Inclusion criteria: aged 70+, not currently exercising more than 1 day per week, self-reported at least two functional limitations, low physical performance
Excluded if: unstable cardiovascular disease, psychiatric disorders, neurological or muscular disease, terminal illness, or cognitive impairment
Number randomised: 34 (Intervention) / 38 (Comparison)
Mean age: 77.8
Sex (% female): 79.2%
Mortality per year in the comparison group: 0.0%
Living alone (%): Not reported
Visitors' professional group: Exercise physiologist
Frequency and duration of visits: 11 visits over 6 months
Fall prevention: No
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visits involved exercise programme focusing on strength, balance, and encouragement to increase overall activity. Visitors gave participants a detailed booklet, dumbbells, and adjustable ankle weights. Physiologist also asked about new medical conditions and falls history.
Description of comparison: Attention-matched control given nutritional education
Implementation (fidelity and participant compliance): Intervention participants completed an average of 82.0% of their prescribed exercise sessions. Comparison participants complied with 75% of their nutrition programme
Functioning ADL/IADL: Physical Performance Test (6 months)
Mortality: Total number of deaths (6 months)
Location: Greater Boston area, Massachusetts, U.S.A.
Funding Source: Brookdale Foundation, U.S. Dept of Agriculture; National Institute of Health, USDA Food and Agriculture Sciences Graduate Fellowship, National Institute on Health Research Training programme in Nutrition and Aging
Other notes: There were two adverse events during the study. One participant in the exercise group fell while doing the tandem walk at home, which resulted in bruises to both arms and one knee, and one participant in the attention-control group had an episode of food poisoning. Both participants were able to continue in the study once they recovered.
Place of recruitment: Databases of six General Practices; solicitation by contacting every 20th name on the register
Inclusion criteria: aged 75+, living independently in community
Number randomised: 50 (Intervention) / 50 (Comparison)
Mean age: 79.2
Sex (% female): 63.0%
Mortality per year in the comparison group: 10.0%
Living alone (%): Not reported
Visitors' professional group: Registered nurse
Frequency and duration of visits: 1 visit over 6 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved in-home health check with emphasis on functional ability. Visitors counted participants' number of health problems and reported them to participants' general practitioners.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 96.0% of intervention participants received the intervention.
Falls People: Total number of people who experienced a fall (12 months)
Functioning ADL/IADL: Barthal Activities of Daily Living Index (12 months)
Functioning Cognitive: Mini-Mental State Examination (12 months)
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for Bodily Pain (12 months); General Health (12 months); Mental Health (12 months); Physical Health (12 months); Role Emotional (12 months); Role Physical (12 months); Social Functioning (12 months); and Vitality (12 months)
Institutionalisation People: Total number of people admitted to nursing home (12 months)
Mortality: Total number of deaths (12 months)
Location: Adelaide Western Division of General Practice, Australia
Funding Source: General Practice Evaluation Programme, Commonweath Department of Health and Aged Care
Other notes:
Place of recruitment: General Practice; method of solicitation not reported.
Inclusion criteria: aged 65+, living in domestic accommodation, registered with the practice
Number randomised: 369 (Intervention) / 356 (Comparison)
Mean age: 73.3
Sex (% female): 59.9%
Mortality per year in the comparison group: 8.43%
Living alone (%): 33.5%
Visitors' professional group: Health professional
Frequency and duration of visits: 9 visits
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: The research team sent screening questionnaires were sent to eligible patients annually. If the questionnaire indicated a problem, a health professional visited the patient at home and provided advice, health education, and referrals to their general practitioners or community services. The visitor was not directly involved in patient care.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 60.0% of intervention participants received a visit.
Health Related QoL: Self-rated health (36 months)
Hospitalisation Admissions: Total number of admissions to hospital (36 months)
Hospitalisation Days: Total number of days in hospital (36 months)
Institutionalisation People: Total number of people admitted to nursing home (36 months)
Mortality: Total number of deaths (36 months)
Location: Cardiff, Wales
Funding Source: Nuffield Provincial Hospital Trust
Other notes:
Place of recruitment: GP registrars; solicited via mail.
Inclusion criteria: aged 70+ years, history of falls.
Excluded if: living in nursing or residential homes, currently receiving occupational therapy, or those who had received a falls-specific OT intervention in the preceding year.
Number randomised: 87 (Intervention) / 78 (Comparison)
Mean age: 78.9
Sex (% female): 69.1%
Mortality per year in the comparison group: 7.7%
Living alone (%): Did not report
Visitors' professional group: Occupational therapist
Frequency and duration of visits: 1 visit lasting 1.5 to 2 hours
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: The visit consisted of an environmental assessment and modification of the home by OT.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): 3.5% of intervention participants refused assessment. 60% participants partially adhered to recommendations for home modification, while 18% fully adhered to recommendations.
Falls Number: Total number of falls (12 months)
Falls People: Total number of people who experienced a fall (12 months)
Falls Subjective: Falls Efficacy Scale International Version (12 months)
Functional ADL/IADL: Barthal Index (12 months)
Health-Related QoL: EuroQol (12 months); SF-12 Physical (12 months); SF-12 Mental (12 months)
Mortality: Total number of deaths (12 months)
Location: Yorkshire, UK
Funding Source: Institute for Health Research National Coordinating Centre for Research Capacity Development; Department of Health Research Capacity Development Programme
Other notes: We did not extract data from a third group that received an intervention delivered by an unqualified trained assessor.
Place of recruitment: Primary care networks; solicited by postal screening of patients from selected family physicians.
Inclusion criteria: aged 75+, spoke English.
Excluded if: needed palliative care, had major surgery scheduled in next year, planned to leave country for more than 1 month in next year.
Number randomised: 361 (Intervention) / 358 (Comparison)
Mean age: 81.1
Sex (% female): 53.1%
Mortality per year in the comparison group: 2.8%
Living alone (%): 33.9%
Visitors' professional group: Home care nurse
Frequency and duration of visits: Average of 3.03 visits over 12 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved a comprehensive initial assessment, collaborative care planning, health promotion, and referral to community health and social support service. Follow-up visits were performed as necessary to encourage adherence.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 100% of intervention participants received the intervention. Intervention participants received a mean of 1.17 telephone calls from the nurse in addition to the home visits over the year.
Functioning ADL/IADL: Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire (12 months)
Health Related QoL: Quality adjusted life years (12 months); Self-rated health (12 months)
Mortality: Total number of deaths (12 months)
Location: Hamilton, Ontario, Canada
Funding Source: Ontario Ministry of Health and Long Term Care, Primary Health Care Transition Fund
Other notes:
Place of recruitment: Computerised registers at 17 General Practices; solicited by mail from doctor.
Inclusion criteria: aged 75+
Excluded if: unable to walk around own residence, receiving physiotherapy, not able to understand the requirements of the trial
Number randomised: 121 (Intervention) / 119 (Comparison)
Mean age: 80.8
Sex (% female): 67.5%
Mortality per year in the comparison group: 5.0%
Living alone (%): 53.0%
Visitors' professional group: Registered nurse
Frequency and duration of visits: 4 visits over 8 weeks, with 1 additional visit at 6 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: Visitors provided individually presecribed sets of muscle strengthening and balance retraining exercises of progressive difficulty, in addition to a walking plan. Visitors expected participants to exercise at least three times a week and to walk twice a week for a year. Nurses called participants to maintain motivation and discuss any problems in months where they did not visit.
Description of comparison: Usual care.
Implementation (fidelity and participant compliance): 82.6% of intervention participants that received intervention. 43.4% of intervention participants carried out their prescribed exercise programme three or more times a week, whereas 66.6% of carried it out at least 2 times per week. 66.1% of intervention participants walked at least 2 times per week at 1 year follow up.
A&E Number: Number of fall-related visits to an A&E department per person (12 months)
Falls Number: Number of falls per person (12 months)
Injuries Number: Number of injurious falls per person (12 months)
Mortality: Total number of deaths (12 months)
Location: West Auckland, New Zealand
Funding Source: Health Funding Authority Northern Division, Accident Rehabilitation and Compensation Insurance Corporation of New Zealand, Trustbank Otago Community Trust research fellowship
Other notes: Estimated cost of intervention was NZ$432 per participant
Place of recruitment: Nordmaling residents; method of solicitation not reported.
Inclusion criteria: 75+, living independently without any home help or home-nursing care
Number randomised: 248 (Intervention)/ 346 (Control)
Mean age: 79.4
Sex (% female): 55.1%
Mortality per year in the Comparison Group: 11.8%
% Living Alone: Not reported
Visitors' professional group: Registered nurse; care visitor
Frequency and duration of visits: 4 visits over 2 years
Fall Prevention: Yes
Included exercise: No
Included Multidimensional Geriatric Assessment: Yes
Description of intervention:
The nurse and care visitor each received half of the participants in the intervention group. They shared knowledge with each other, as they had different professional backgrounds. Visits lasted 1.5-3 hours and followed structured programme on general health information and risks for falling, with each visit focusing on a different topic. Visitors used a structured questionnaire as an interview guide and evaluation tool. Visitors followed-up with needed services before the next home visit.
Description of comparison: Usual care
Implementation (fidelity and participant compliance):
78.7% (196/249) of randomised participants that received intervention
Mortality: Mortality (24, 58 months)
Location: Nordmaling, Sweden
Funding Source: Swedish National Institute of Public Health
Other notes:
Place of recruitment: State of Florida's Community Care for Elderly programme; solicited by telephone call from case managers
Inclusion criteria: Older adults on waiting list to receive social services and considered "moderate risk"
Number randomised: 40 (Intervention) / 65 (Comparison)
Mean age: 77.3
Sex (% female): 80.0%
Mortality per year in the comparison group: 4.1%
Living alone (%): Not reported
Visitors' professional group: Registered nurse
Frequency and duration of visits: 1 initial visit and then varied follow-up visits over 18 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved in-home geriatric assessment, with tailored services provided to address specific needs and problems. Services included homemaking, home delivered meals, help with chores, emergency alert response system, personal care, consumable medical supplies, medical transportation, and respite.
Description of comparison: Wait-list control
Implementation (fidelity and participant compliance): 93.0% of intervention participants received the intervention.
Health Related QoL: Life Satisfaction (18 months)
Institutionalisation People: Total number of people admitted to nursing home (18 months)
Mortality: Total number of deaths (18 months)
Psychiatric Anxiety and Depression: Center for Epidemiologic Studies Depression Scale (CES - D) (18 months)
Location: Florida, U.S.A.
Funding Source: Borchard Center Foundation on Law and Aging, the United Way of Northeast Florida, and Baptist and St. Vincent’s Hospitals
Other notes: Estimated cost of intervention was US$2300 per participant
Place of recruitment: Patients from 18 primary care physician registers; solicited by mailed baseline questionnaire and cover letter.
Inclusion criteria: aged 65+, one or more visits to primary care physician in previous 3 months, did not require 24 hour care, low daily functioning, under treatment for at least 2 chronic conditions, spoke proficient English, living independently, not under therapy for cognitive decline
Number randomised: 383 (Intervention) / 351 (Comparison)
Mean age: 77.5
Sex (% female): 68.5%
Mortality per year in the comparison group: 3.7%
Living alone (%): 48.6%
Visitors' professional group: Registered nurse, social worker
Frequency and duration of visits: 1 initial visit and then varied follow-up visits over 18 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visitors listened to health concerns, took vital signs and health histories, and completed a functional assessment and home safety check. Visitors then generated frailty and health risk scores, and drafted a risk reduction plan to set target objectives and plan self management strategies. Visitors also monitored health status between office visits every six weeks and revised care plan on basis of feedback.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Intervention participants averaged 34 nurse or social contacts (range 1 – 176). 7% of intervention participants received less than 10 contacts, 47% received 10-29 contacts, and 46% received 30 to 176 contacts. Contacts lasted an average of 22 minutes per intervention participant and occurred every 21 days.
A&E People: Total number of people admitted to an A&E department (12, 24 months)
Functioning ADL/IADL: Health Activities Questionnaire (24 months)
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 (24 months); Symptom Scale (24 months)
Hospitalisation Admissions: Total number of hospital admissions (12, 124 months)
Institutionalisation People: Total number of people admitted to nursing home (12, 24 months)
Mortality: Total number of deaths (24 months)
Psychiatric Anxiety and Depression: Geriatric Depression Scale (24 months)
Location: San Francisco, California, U.S.A.
Funding Source: John A Hartford Foundation.
Other notes:
Place of recruitment: Central National Register for the general population of Copenhagen; solicited by visit from a social worker and physician
Inclusion criteria: aged 75+, registered in the Copenhagen Central National Register
Number randomised: 778 (Intervention) / 777 (Comparison)
Mean age: 79.8
Sex (% female): 48.2%
Mortality per year in the comparison group: Not reported
Living alone (%): Not reported
Visitors' professional group: Physician, social worker
Frequency and duration of visits: 1 initial 2-hour visit over 1 year
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Physician carried out general medical examination to establish need for health intervention. Social worker asked questions about housing conditions, economy, social support, and social network. If any unmet social needs were disclosed, social services were informed to request support. Participants' general practitioners were informed via mail of the social and medical conclusions made at the visit.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
Falls People: Total number of people who experienced a fall (30 months)
Health Related QoL: Subjective health (30 months)
Hospitalisation People: Total number of people hospitalised (30 months)
Institutionalisation People: Total number of people admitted to nursing home (30 months)
Location: Copenhagen, Denmark
Funding Source: The Danish Health Insurance Foundation
Other notes:
Place of recruitment: State electoral roll; solicited by mail and telephone
Inclusion criteria: cognitively intact, able to speak English, didn’t plan to move, able to modify their homes, had no ramps or grab rails
Number randomised: 635 (Intervention) / 1244 (Comparison)
Mean age: 76.9
Sex (% female): 52.3%
Mortality per year in the comparison group: Not reported
Living alone (%): Not reported
Visitors' professional group: Research nurse
Frequency and duration of visits: 1 visit
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: No
Description of intervention: Before the visit, participants received information about the intervention and fall reduction strategies. Visits began with an educational session about recognising a fall. Then, visitors offered participants a home hazard assessment, installed safety devices, and provided more education about fall hazards.
Description of comparison: Attention-matched control
Implementation (fidelity and participant compliance): 89.8% of intervention participants received the intervention.
A&E Number: Number of fall-related visits to an A&E department per person (12 months)
Falls Number: Number of falls per person (12 months)
Falls People: Total number of people who experienced a fall (12 months)
Injuries Number: Number of injurious falls per person (12 months)
Location: Perth metropolitan area, Western Australia
Funding Source: Western Australian Health Promotion Federation, Lotteries Commission of Western Australia, and Health Department of Western Australia
Other notes:
Place of recruitment: Voter-registration list; solicited by phone, mail, and personal contact.
Inclusion criteria: aged 75+, living at home
Excluded if: severe cognitive impairment, language problems, plans to move to a nursing home, plans to move away, self-reported terminal disease, participation in another randomised trial, and severe functional impairment
Number randomised: 215 (Intervention) / 199 (Comparison)
Mean age: 81.2
Sex (% female): 70.0%
Mortality per year in the comparison group: 4.4%
Living alone (%): 64.0%
Visitors' professional group: Gerontologic nurse practitioner
Frequency and duration of visits: 10.9 visits on average over 3 years
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved in-home asssessment of medical history, physical and mental health status, medications, quality of social support, home hazards, and other falls risk factors. Practitioners discussed each case with geriatricians, developed rank-order recommendations, and conducted in-home visits every 3 months to monitor implementation of recommendations, make additional recommendations, and facilitate compliance. Telephone contact was also available.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 6.0% of intervention participants were never seen. Of the remaining 202 intervention participants, 24.3% did not complete the programme. Each year, intervention participants received an average of 5.9 recommendations about self-care, 3.3 recommendations to discuss new problems and treatement with physicians, and 2.3 recommendations about community services. Intervention participants adhered to 47.0% of all recommendations, did not adhere to 39.0%, and partly adhered to 14.0%.
Functioning ADL/IADL: Activities of Daily Living Composite (36 months); Instrumental Activities of Daily Living Composite (36 months)
Hospitalisation Days: Number of days in hospital per person (36 months)
Hospitalisation People: Total number of people hospitalised (12, 36 months)
Institutionalisation Days: Number of days in a nursing home per person (36 months)
Institutionalisation People: Total number of people admitted to nursing home (36 months)
Mortality: Total number of deaths (36 months)
Location: Santa Monica, California, U.S.A.
Funding Source: W.K. Kellogg Foundation, Swiss National Science Foundation, Senior Health and Peer Counseling, and the Swiss Foundation for Biological and Medical Grants
Other notes:
Place of recruitment: Health insurance list of community-residing subjects; method of solicitation not reported.
Inclusion criteria: aged 75+; living in 3 eligible zip code areas in Bern
Excluded if: living in a nursing home or board and care facility, did not speak German, had a terminal disease
Number randomised: 264 (Intervention) / 527 (Comparison)
Mean age: 81.7
Sex (% female): 73.1%
Mortality per year in the comparison group: 4.2%
Living alone (%): 55.0%
Visitors' professional group: Certified registered nurses with an additional degree in public health nursing
Frequency and duration of visits: 8 visits over 24 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved multidimensional geriatric assessments in participant homes. Nurses prepared a falls problem list, discussed it with the project geriatrician, developed recommendations, and conducted follow-up visits with participants every 3 months to encourage/monitor compliance and provide education. If medical problems were urgent, the project geriatrician could call participants’ physicians. A physical therapist, occupational therapist, and social worker discussed complex psychosocail problems.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 2.7% of intervention participants refused visits. Of the remaining 249 intervention participants, each participants received an average of 8.5 visits during the 24 months of the programme. Greater than 90% of intervention participants’ primary care general practitioners were contacted during the intervention by a project geriatrician.
Functioning ADL/IADL: Total number of people dependent in basic ADL (36 months); total number of people dependent in basic IADL (36 months)
Institutionalisation People: Total number of people admitted to nursing home (36 months)
Mortality: Total number of deaths (36 months)
Location: Bern, Switzerland
Funding Source: Swiss National Science Foundation, Cantonal Department of Health and Social Affairs, W.K. Kellogg Foundation, Novartis Foundation for Gerontological Research, and Visana Health Insurance Company
Other notes: Estimated cost of intervention was US$276 per participant
Place of recruitment: Households in eastern Newfoundland phone book; solicitation by random-digit dialing of all households
Inclusion criteria: aged 75+, participant and caregiver both mentally competent, not receiving formal home care, able to identify an informal caregiver, English-speaking
Number randomised: 175 (Intervention Group 1), 170 (Intervention Group 2) / 175 (Comparison)
Mean age: 80.6
Sex (% female): 67.5%
Mortality per year in the comparison group: 7.0%
Living alone (%): 46.3%
Visitors' professional group: Nurse
Frequency and duration of visits: 4 visits over 48 months
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention:
Group 1: Visits involved a comprehensive assessment. Visitors shared results with participants and their caregivers.
Group 2: Same as Group 1, except that visitors also referred participants to health and social services.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 100% of intervention participants received the intervention.
Functioning, Cognitive: Mini-Mental State Examination (12, 24, 36, 48 months)
Health Related QoL: Household Survey of Canada’s National Health Population Survey (12, 24, 36, 48 months)
Institutionalisation People: Total number of people admitted to nursing home (48 months)
Mortality: Total number of deaths (48 months)
Location: Newfoundland, Canada
Funding Source: Not reported
Other notes:
Place of recruitment: Health Maintenance Organization in Southern Connecticut; solicited by in-person contact at physicians' practices.
Inclusion criteria: aged 70+, ambulatory, had at least 1 risk factor for falling, not demented, no participation in vigorous sports or walking, not enrolled in another study of ageing
Number randomised: 153 (Intervention) / 148 (Comparison)
Mean age: 77.9
Sex (% female): 69.1%
Mortality per year in the comparison group: 3.4%
Living alone (%): Not reported
Visitors' professional group: Initial visits by nurse practitioner, then physical therapist
Frequency and duration of visits: 7.8 visits on average over 3 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: Yes
Description of intervention: Visitors instructed participants to perform strength exercises twice a day for 15-20 minutes per session. Visits also included behavioural modification instructions and medication adjustment later discussed with a general practitioner.
Description of comparison: Attention-matched control
Implementation (fidelity and participant compliance): 94.8% of intervention participants received the intervention. Intervention participants reported that they completed 73.0% of the recommended exercise sessions.
A&E Number: Number of fall-related visits to an A&E department per person (12 months)
A&E People: Total number of people admitted to an A&E department due to fall (12 months)
Falls Number: Number of falls per person (12 months)
Falls People: Total number of people who experienced a fall (3, 6, 9, 12 months)
Falls Subjective: Falls self-efficacy (12 months)
Hospitalisation Admissions: Total number of hospital admissions (12 months)
Hospitalisation Days: Total number of days in hospital (12 months)
Hospitalisation People: Total number of people hospitalised (12 months)
Injuries Number: Total number of fall-related injuries (12 moths)
Injuries People: Total number of people with a serious injury due to a fall (12 months)
Mortality: Total number of deaths (12 months)
Location: Southern Connecticut, U.S.A.
Funding Source: National Institute on Aging
Other notes: Estimated cost of intervention was US$891 per participant
Place of recruitment: General Practices; method of solicitation not reported
Inclusion criteria: aged 70+, ambulatory, moderate impairments in mobility or a recent history of falls.
Excluded if: fully dependent on a wheelchair, on waiting list for a nursing home, or already receiving regular visits from health professional
Number randomised: 159 (Intervention) / 157 (Comparison)
Mean age: 77.2
Sex (% female): 66.1%
Mortality per year in the comparison group: 5.9%
Living alone (%): 50.0%
Visitors' professional group: Community nurse
Frequency and duration of visits: 5 visits over 12 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits included screening for medical, environmental, and behavioural risks for falls. Nurses followed-up the assessment with advice, referrals, and other actions aimed at reducing falls hazards. Nurses also assessed social and physical functioning, and completed a checklist for home safety.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 86.8% of intervention participants received the intervention. Intervention participants complied with 46.0% of the advice given by nurses.
A&E Number: Number of fall-related visits to an A&E department per person (12, 18 months)
Falls People: Total number of people who experienced a fall (12, 18 months)
Falls Subjective: Fear of falling (12, 18 months)
Functioning ADL/IADL: Mobility Control (12, 18 months); Frenchay Activities Index (12, 18 months)
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for Mental Health (12, 18 months) and Physical Health (12, 18 months)
Injuries Number: Total number of injurious falls (12, 18 months)
Mortality: Total number of deaths (18 months)
Location: Hoensbroek, the Netherlands
Funding Source: Zorg Onderzoek Nederland and Stichting Onderzoek en Ontwikkeling Maatchappelijke Gezondheidzorg
Other notes:
Place of recruitment: Primary care practices; solicited by mail
Inclusion criteria: aged 75+, self-reported frailty
Excluded if: terminally ill, demented, participating in another research project
Number randomised: 331 (Intervention) / 320 (Comparison)
Mean age: 81.4
Sex (% female): 70.5%
Mortality per year in the comparison group: 6.5%
Living alone (%): 54.8%
Visitors' professional group: Nurse
Frequency and duration of visits: Minimum of 4 visits over 12 months
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved assessement of care needs, identification of health risks, determination of care priorities, and design and execution of individually tailored interventions. Follow-ups by telephone and additional home visits were provided as needed.
Description of comparison: Usual care
Implementation (fidelity and participant compliance):
90.0% of intervention participants received the intervention. 67.1% of intervention participants met the protocol requirement of four or more visits.
A&E People: Total number of people admitted to an A&E department at least once (18 months)
Functioning ADL/IADL: Groningen Activity Restriction Scale (18 months)
Health Related QoL: Medical Outcomes Study Short Form Health Survey-36 items for Mental Health (6, 18 months) and Physical Health (6, 18 months)
Hospitalisation People: Total number of people admitted to hospital (18 months)
Institutionalisation People: Total number of people admitted to nursing home (18 months)
Mortality: Total number of deaths (18 months)
Location: Netherlands
Funding Source: Netherlands Organization for Health Research
Other notes:
Place of recruitment: residents in regional area of Weert; solicited by postal questionnaire
Inclusion criteria: aged 75-84.
Excluded if: receiving regular home nursing care
Number randomised: 292 (Intervention) / 288 (Comparison)
Mean age: 78.7
Sex (% female): 57.8%
Mortality per year in the comparison group: 5.8%
Living alone (%): 39.0%
Visitors' professional group: Public health nurses
Frequency and duration of visits: Minimum of 4 visits per year over 3 years
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Nurses used a standardised checklist containing questions about functional state, medication, social contacts, and housing conditions. Participants could also phone the nurse to ask questions or ask for a visit. Visits focused on improving quality of life and included discussion of health topics and referrals as needed.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 97.6% of intervention participants received the intervention. 2.4% of intervention participants refused visits. 32.9% of intervention participants received a total of 174 extra visits. 52.7% of intervention participants were advised to contact other services.
Functioning ADL/IADL: Activities of Daily Living Disabilities (36 months); Household disabilities (36 months)
Health Related QoL: Self-rated health (18, 36 months)
Hospitalisation Admissions: Total number of hospital admissions (12, 24, 36 months)
Hospitalisation Days: Total number of days in hospital (12, 24, 36 months)
Hospitalisation People: Total number of people hospitalised (12, 24, 36 months)
Institutionalisation Days: Total number of days in a nursing home (36 months)
Institutionalisation People: Total number of people admitted to nursing home (36 months)
Mortality: Total number of deaths (12, 24, 36 months)
Location: Weert, Netherlands
Funding Source: Not reported
Other notes:
Place of recruitment: General Practices; solicited by in-person contact at participants' homes
Inclusion criteria: born before 1909, living at home
Number randomised: 281 (Intervention) / 273 (Comparison)
Mean age: 77.5
Sex (% female): Not reported
Mortality per year in the comparison group: 8.2%
Living alone (%): Not reported
Visitors' professional group: Health visitor
Frequency and duration of visits: 1 visit per year over 2 years
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved an in-home, semi-structured interview regarding participants' physical, mental, and social characteristics. Visits also included health education and prevention, referrals to a range of services, and follow-up of those services. Participants completed a problems sheet and treatment procedure form at each interview.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Intervention participants received a total of 528 visits
Functioning ADL/IADL: Townsend's disability scale (24 months)
Health Related QoL: Subjective view of life overall (24 months)
Mortality: Total number of deaths (24 months)
Psychiatric Anxiety and Depression: Anxiety (24 months)
Location: Powys, Wales
Funding Source: Welsh Office and the Department of Health and Social Security (Office of the Chief Scientist)
Other notes:
Place of recruitment: General Practices; solicited by in-person contact at participants' homes
Inclusion criteria: born before 1909, living at home
Number randomised: 296 (Intervention) / 298 (Comparison)
Mean age: 76.8
Sex (% female): Not reported
Mortality per year in the comparison group: 10.1%
Living alone (%): Not reported
Visitors' professional group: Health visitor
Frequency and duration of visits: 1 visit per year over 2 years
Fall prevention: No
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits involved an in-home, semi-structured interview regarding participants' physical, mental, and social characteristics. Visits also included health education and prevention, referrals to a range of services, and follow-up of those services. Participants completed a problems sheet and treatment procedure form at each interview.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Intervention participants received a total of 528 visits.
Functioning ADL/IADL: Townsend's disability scale (24 months)
Health Related QoL: Subjective view of life overall (24 months)
Mortality: Total number of deaths (24 months)
Psychiatric Anxiety and Depression: Anxiety (24 months)
Location: Gwent, Wales
Funding Source: Welsh Office and the Department of Health and Social Security (Office of the Chief Scientist)
Other notes:
Place of recruitment: General Practice; solicited by in-person contact at participants' homes.
Inclusion criteria: aged 70+
Number randomised: 350 (Intervention) / 324 (Comparison)
Mean age: 76.8
Sex (% female): Not reported
Mortality per year in the comparison group: 8.2%
Living alone (%): Not reported
Visitors' professional group: Health visitor
Frequency and duration of visits: Minimum of 1 visit per year over 4 years
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: Yes
Description of intervention: Visitors obtained a history of illness and focused on four factors: nutrition, medical conditions, environment, and muscle tone. Local voluntary agencies were recruited to fix environmental hazards. A part-time physiotherapist helped with fitness classes for moderately disabled people. Visitors referred participants to other professionals as needed.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): Not reported
A&E People: Total number of people admitted to an A&E department due to fall (48 months)
Falls People: Total number of people who experienced a fall (48 months)
Injuries People: Total number of people who experienced a fracture due to a fall (48 months)
Mortality: Total number of deaths (48 months)
Location: Wales
Funding Source: Grand Charity and Welsh Office
Other notes:
Place of recruitment: Health Care Financing Administration list of female Medicare beneficiaries; solicited by mailing a random sample of the list.
Inclusion criteria: aged 70+, female, Medicare beneficiary, living independently, postural instabilty, low cognitive impairment, at least 1 injurious fall factor, physician clearance for exercise, available for follow-up appointments, proficiency in English.
Excluded if: unable to walk 30 feet without stopping or assistive device, involved in regular exercise, unstable health conditions preventing safe, independent exercise, terminal illness.
Number randomised: 137 (Intervention) / 135 (Comparison)
Mean age: 78.8
Sex (% female): 100.0%
Mortality per year in the comparison group: 0.0%
Living alone (%): 48.9%
Visitors' professional group: Registered nurse
Frequency and duration of visits: 1 visit every other week over 12 weeks
Fall prevention: Yes
Included exercise: Yes
Included multidimensional geriatric assessment: No
Description of intervention: The intervention involved a multidimensional, 12-week programme alternating between home visits and phone calls. The programme included an exercise programme (Weeks 1-3), an individualised fall risk profile including environmental hazards (Week 5), fall and home safety education and evaluation (Weeks 5-13), two nightlights, individualised counseling, and referrals to other services as needed.
Description of comparison: Education about topics unrelated to falls prevention
Implementation (fidelity and participant compliance): 91.9% of intervention participants received the full allocated intervention. 5.1% received a partial version of the allocated intervention. 97.0% of comparison participants received the comparison treatment. The intervention participants received an average of 6.6 home visits and 5.5 telephone calls. Comparison participants received a mean of 6.7 home visits and 5.4 telephone calls. 62.0% of intervention participants set at least one goal for correcting an environmental hazard, 7.3% refused to make an action plan to reduce their fall risk factors, and 34.3% actually made one or more home modifications by follow-up.
Falls Number: Total number of falls (12 months)
Falls People: Total number of people who experienced a fall (12 months)
Mortality: Total number of deaths (12 months)
Location: Twin Cities Metropolitan Area, Minnesota, U.S.A.
Funding Source: National Institute of Nursing Research and the Office of Research on Women’s Health, National Institutes of Health
Other notes:
Place of recruitment: Voter registration list of two geographic areas; solicited by mail
Inclusion criteria: aged 65+, community-dwelling, dependent in instrumental activities of daily living, independent in activities of daily living
Excluded if: dependent on mobility or personal care
Number randomised: 184 (Intervention) / 184 (Comparison)
Mean age: 78.7
Sex (% female): 63.3%
Mortality per year in the comparison group: 5.4%
Living alone (%): 9.2%
Visitors' professional group: Public health nurses
Frequency and duration of visits: 5.1 visits on average over 18 months
Fall prevention: Yes
Included exercise: No
Included multidimensional geriatric assessment: Yes
Description of intervention: Visits were human-interaction focused and involved flexible approach. Initial visits involved multidimensional geriatric assessments, which informed further assessments and treatment recommendations. Visits stopped if a participant was institutionalised and were restarted after hospitalisation.
Description of comparison: Usual care
Implementation (fidelity and participant compliance): 100% of intervention participants received the intervention.
Health Related QoL: Euroqol-5 Dimensions Weighted Index (18 months)
Institutionalisation People: Total number of people in nursing home at end of study (18 months)
Mortality: Total number of deaths (18 months)
Location: Sapporo city and Takahata town, Japan
Funding Source: Ministry of Health and Welfare in Japan
Other notes:
Intervention for families, not for the elderly themselves.
Visits not conducted by health professional.
Visits not conducted by health professional.
Intervention not a home visit: intervention conducted in community venue with follow-up home visit.
Ineligible comparison: both intervention and control groups received home visits.
Only 8.8% of intervention participants opted for home visits.
Intervention not a home visit. All arms of intervention (including controls) were assessed at home by nurses.
Home visits not part of intervention.
Visit directly related to hospital discharge.
Intervention not a home visit: intervention carried out in out-patient clinic.
Intervention not a home visit: assessment conducted in hospital.
Intervention not a home visit.
Visit directly related to hospital discharge.
Intervention not a home visit: less than half the assessments were conducted in participants’ homes.
Intervention not a home visit: health appraisal took place during office visits.
Only 50.0% of intervention participants opted for home visits.
Intervention not a home visit: preventive visits took place at physician’s office.
Inelgible comparison: both intervention and control groups received home visits.
Home visits not carried out by health professionals. Quasi experimental design.
Visit directly related to hospital discharge.
Intervention not a home visit: screening took place in primary care practice.
Not a randomised controlled trial: study refusers did not have equal chance of being assigned to either group. Informed consent followed randomisation.
Visits not conducted by health professional.
Not a randomised controlled trial.
Visits not conducted by health professional – students.
Intervention targeted general practitioners.
Intervention targeted visitors.
Intervention not a home visit: centre-based intervention.
Intervention not a home visit: intervention carried out at senior centre.
Inelgible comparison: both intervention and control groups received home visits.
Visits directly related to rehabilitation and delivered to non-independent elderly.
The intervention group received an initial assessment at home with follow-up home visits, and the control group was assessed in hospital and received follow-up home visits. As both groups received home visits as part of their allocated intervention, the comparison was ineligible.
The intervention group received an initial assessment at home with follow-up home visits, and the control group was assessed in hospital and received follow-up home visits. As both groups received home visits as part of their allocated intervention, the comparison was ineligible.
Inelgible comparison: both intervention and control groups received home visits.
Visit directly related to hospital discharge.
Some participants were living in a home for the aged.
Some participants were living in a home for the aged.
Visit directly related to hospital discharge. Not a randomised controlled trial.
Intervention not a home visit.
Intervention not a home visit: only 1% of visits were conducted in participant’s homes.
Not a randomised controlled trial: intervention and control groups recruited over different time period.
Inelgible comparison: both intervention and control groups received home visits.
Home visits not part of intervention.
Intervention focused on providers.
Study not a randomised controlled trial: quasi-experimental design.
Study not a randomised controlled trial.
Study not a randomised controlled trial.
Intervention not a home visit.
Intervention not a home visit.
Intervention not a home visit.
Intervention not a home visit.
Not all participants required to have home visits as part of intervention.
Intervention was not a multidimensional geriatric assessment nor usual health visiting practice, but an advanced, home-delivered cognitive-behavioral therapy.
Intervention not a home visit: geriatric assessment took place in outpatient clinic.
Intervention not a home visit.
Intervention not a home visit.
Intervention not a home visit.
Intervention not preventative and not a home visit.
Visits not conducted by health professional – student OTs.
Inelgible comparison: both intervention and control groups received home visits.
Not a randomised controlled trial: no control group.
Intervention not a home visit.
Visit directly related to hospital discharge.
Intervention not a home visit.
Intervention not a home visit.
Intervention targeted visitors.
Study not a randomised controlled trial.
Intervention not a home visit.
Intervention not a home visit.
Intervention not a home visit.
Visit directly related to hospital discharge.
Visit directly related to hospital discharge.
Participants resided in retirement communities.
Intervention not a home visit.
Visits not conducted by a health professional - masters students.
Intervention not a preventive home visit: visits to homebound, chronically or terminally ill patients.
Selection bias (biased allocation to interventions) due to inadequate generation of a randomised sequence
Quote: "randomization tables were used"
Quote: "subjects were randomly stratified by age and sex according to a computer generated list"
Quote: "computer-generated randomization list"
Quote: "randomly allocated by computer using Statistical Applications Software (SAS) to one of four intervention groups or the control group"
Quote: "the group allocation schedule was developed by a statistician using computer generated random numbers"
Quote: "a statistician developed the group allocation schedule using computer generated random numbers"
Quote: "patients were randomized using computer-generated random numbers"
Quote: "subjects were then block-randomized and stratified by the two levels of functioning"
Quote: "eligible patients were randomised, using a computer-generated randomisation scheme under the supervision of the study biostatistician"
Quote: "using 50:50 randomized allocation ratio, investigators created envelopes containing concealed assignment codes assigned sequentially to eligible patients in blocks of 10 by a research associate"
Comment: No mention of how assignment codes were generated
Quote: “Randomisation was by a random-numbers table.”
Quote: "randomization lists were generated by the study biostatistician (T.E.S.) with the aid of [a] pseudorandom-number generator"
Quote: "random assignment ... was accomplished using SAS software"
Quote: "random numbers table"
Quote: "randomisation was by computer-generated block randomisation"
Quote: "computer-based schedule generated by a statistician"
Quote: "randomly generated assignment cards in sealed envelopes"
Quote: "randomly assigned"
Quote: "study participants were ... randomized within each of four strata using random permuted blocks to control for possible changes in subject mix over time. The blocking number [was] developed by the project statistician"
Quote: "prepared from random number tables and used four length random permuted blocks"
Quote: "The material used is a random sample taken from the national person register systematically stratified for age. . . The sample was then randomized into an experimental group and a control group by consecutively and alternately dividing it into the two groups"
See allocation concealment.
Quote: "randomisation was done in blocks of four, using a table of random numbers"
Quote: "the randomization lists were generated with random permutated blocks of 4-6"
Quote: "computerized alternate random allocation"
Quote: "the allocation sequence was computer generated"
Quote: "computer generated sequence in blocks of varying length"
Quote: "half of the sample was randomly assigned as the experimental group, and the other half as the comparison group"
Quote: "randomly allocated to control or intervention groups"
Quote: "randomly assigned to intervention or control group"
Quote: “The remaining 323 participants were randomized to either the interven- tion group (n = 161) or usual care group (n = 162) by re- searchers using computer-generated random numbers stratified on the basis of gender, age group, and district within each community.”
Quote: "a prospective, single-blinded, randomized trial"
Quote: "randomisation was carried out by a third party, and was stratified by whether the patient lived alone"
Quote: “Patients were block-randomized consecutively to groups.”
Quote: "participants were block randomized in groups of six to one of three intervention programs"
Quote: "the randomization sequence was computer generated (www.randomization.com)"
Quote: "the subjects were randomly allocated to either the experimental or control groups"
Quote: "randomization was done by the study statistician using a random numbers table"
Quote: "eligible and consenting participants were randomized ... using a computerized randomization schedule"
Quote: "randomly generated numbers constructed by a biostatistician who was not involved in the recruitment process"
Quote: "elderly people were stratified into the age-sex groups ..., then randomly allocated to the test ... and control groups"
Quote: "participants were randomly assigned to either group in blocks of four by gender and age (70–79 years/80 years or older)"
Quote: "randomisation was by random numbers contained in sequentially numbered, sealed envelopes"
Quote: "patients were randomly allocated to intervention or control"
Quote: “The York Trials Unit independently and remotely conducted simple Web-based randomization because the anticipated sample size of the trial was to exceed 100."
Quote: "the random numbers used to assign the block size and choice of allocation within blocks came from the Rand tables of random digits"
Quote: "a statistician developed the schedule for group allocation using random numbers"
Used birth date for randomisation. Quote: "those whose birth date was divisible by 3 were assigned to the intervention."
Quote: "randomly assigned using a random number generator" and "three members of the intervention group were removed from the study after baseline ... and were replaced by three members of the comparison group"
Quote: "the 13 internists and 5 family physicians were randomized, by means of a random number table"
Quote: "stratified random sampling among 75-, 80- and 85-year-old citizens"
Quote: "index recruits were allocated in a 2:1 ratio to either the control (C) or the intervention (I) group"
Quote: "randomization was performed with sealed envelopes containing random numbers"
Quote: "an independent test center calculated the treatment assignment based on a random letter table and informed the project team"
Quote: "computer generated random numbers"
Quote: "random number generator on SAS software"
Quote: "The people in the study were then randomly allocated by household to a group receiving intervention and a control group."
Quote: "The people in the study were then randomly allocated by household to a group receiving intervention and a control group."
Quote: "the randomisation was carried out ... using random number tables"
Quote: "participants were stratified according to age group ... and randomised using a permuted block design"
Quote: "computerised central randomisation scheme generated by one of the research officers"
Quote: "eligible patients were randomised to the home visit group or usual care group by computer generated random numbers directly after screening"
Quote: "we used Pocock’s random number table and assigned up to 10 blocks per practice"
Quote: "randomisation was performed within each stratum by means of random numbers generated by computer"
Selection bias (biased allocation to interventions) due to inadequate concealment of allocations prior to assignment
Quote: "the director of the home visit program recalled that the home visit staff had allowed 'one or two' patients to be transferred from the experimental group to control group"
Quote: "subjects were randomly stratified by age and sex according to a computer generated list"
Quote: "the random allocation sequence was conducted using a computer-generated randomization list with a block length of 4"
Quote: "participants who returned written consent to the study team were entered into the study database by the data manager and randomly allocated by computer using Statistical Applications Software (SAS) to one of four intervention groups or the control group"
Quote: "the [random sequence] list was held off site by an independent person"
Quote: "the schedule was held by an independent person at a separate site and was accessed by a research administrator for the study, who telephoned after each baseline assessment was completed"
Quote: "patients were randomized using computer-generated random numbers coded into opaque envelopes"
Quote: "subjects were then block-randomized and stratified by the two levels of functioning"
Quote: "eligible patients were randomised, using a computer-generated randomisation scheme under the supervision of the study biostatistician"
Quote: "using 50:50 randomized allocation ratio, investigators created envelopes containing concealed assignment codes assigned sequentially to eligible patients in blocks of 10 by a research associate"
Quote: “the [random numbers] list was held independently of the investigators.”
Quote: "randomization lists were generated by the study biostatistician (T.E.S.) with the aid of [a] pseudorandom-number generator"
Quote: "random assignment to the intervention group or attentional comparison group was accomplished using SAS software"
Quote: "the randomization schedule was developed by another research assistant, who was not involved in the randomization [i.e., allocation] process"
Quote: "randomisation was by computer-generated block randomisation"
Quote: "an independent researcher at a distant site randomly allocated participants to the intervention or control group using a computer-based schedule generated by a statistician"
Quote: "randomly generated assignment cards in sealed envelopes"
Quote: "randomly assigned"
Quote: "randomization lists and four sets of randomization were prepared using double, opaque envelope"
Quote: "numbered, sealed, opaque envelopes"
Quote: "patients were assigned ... by an assistant, who was otherwise unconnected with the study"
Quote: "The material used is a random sample taken from the national person register systematically stratified for age. . . The sample was then randomized into an experimental group and a control group by consecutively and alternately dividing it into the two groups"
Quote: “An independent researcher, not involved in the enrolling of participants or in the interventions, organized the allocation system used. A research assistant consecutively and randomly assigned the study participants to one of the three study arms using opaque sealed envelopes.”
Quote: "clients who consented to participate in the study were randomly assigned"
Quote: "randomized either to the study group ... or the control group"
Quote: "an external agency allocated eligible participants who signed the informed consent form and returned a completed baseline questionnaire"
Quote: "[the allocation sequence was] concealed (in a locked cabinet) prior to randomization"
Quote: "we used third party telephone randomisation"
Quote: "half of the sample was randomly assigned as the experimental group, and the other half as the comparison group
Quote: "randomly allocated to control or intervention groups"
Quote: "sealed envelopes"
Did not report.
Quote: "a prospective, single-blinded, randomized trial."
Quote: "randomisation was carried out by a third party"
See sequence generation.
Quote: "participants were block randomized in groups of six to one of three intervention programs"
Quote: "the Family Practice Research Coordinator at the University of British Columbia held this sequence independently and remotely"
Quote: "the subjects were randomly allocated to either the experimental or control groups"
Quote: "randomization was done by the study statistician using a random numbers table"
Quote: "eligible and consenting participants were randomized ... using a computerized randomization schedule"
Quote: "randomization was achieved using consecutively numbered, sealed, opaque envelopes"
Quote: "elderly people were stratified into the age-sex groups ..., then randomly allocated to the test ... and control groups"
Quote: "participants were randomly assigned to either group in blocks of four by gender and age (70–79 years/80 years or older)"
Quote: "randomisation was by random numbers contained in sequentially numbered, sealed envelopes"
Quote: "patients were randomly allocated to intervention or control"
Quote: “The computer-generated outcome of randomization was automatically e-mailed to an independent person who passed the participant’s case notes on to the contact person for the group to which they had been randomized.”
Quote: "the allocation sequence was kept in the locked office of the statistician and was inaccessible to staff making decisions about patients’ eligibility"
Quote: "a statistician developed the schedule for group allocation using random numbers, and this was held at another centre. Participants were then informed of their group allocation by telephone"
Used birth date for randomisation. Quote: "those whose birth date was divisible by 3 were assigned to the intervention."
Quote: "three members of the intervention group were removed from the study after baseline ... and were replaced by three members of the comparison group"
Quote: "the 13 internists and 5 family physicians were randomized, by means of a random number table"
Quote: "stratified random sampling among 75-, 80- and 85-year-old citizens"
Quote: "Recruitment and allocation were by different recruitment officers, who were unaware of each others' activities, and therefore the allocation of subjects was concealed before their agreement to participate and determining their experimental status"
Quote: "randomization was performed with sealed envelopes containing random numbers"
Quote: "an independent test center calculated the treatment assignment based on a random letter table and informed the project team"
Quote: "allocation was concealed from the RNs until they began working with individual clients"
Quote: "random number generator on SAS software"
Quote: "randomly selected from the age-sex register"
Quote: "randomly selected from the age-sex register"
Comment: The authors did not report any other information
Quote: "the randomisation was carried out ... using random number tables"
Quote: "participants were stratified according to age group ... and randomised using a permuted block design"
Quote: "computerised central randomisation scheme generated by one of the research officers"
Quote: "eligible patients were randomised to the home visit group or usual care group by computer generated random numbers directly after screening"
Quote: "An independent statistician kept the assignment lists and assigned individuals to the intervention or control groups"
Quote: "randomisation was performed within each stratum by means of random numbers generated by computer"
Performance bias or detection bias due to knowledge of the allocated interventions after assignment
Quote: "data collection began with an abstract of the Family Practice Center patient charts for all 198 study participants.... Data were collected on precoded forms"
Quote: "information on outcomes ... was collected every 2 months by a research assistant unaware of patients’ assignments"
Quote: "individual interviews conducted by six trained, independent interviewers, blinded to group allocation"
Quote: "interviewers were not part of the intervention team and were blinded to participants’ trial status"
Quote: "the investigator classifying fall events remained blind to group allocation"
Quote: "the independent assessor ... remained blind to group allocation"
Quote: "almost half conducted by a research assistant, with the rest performed by different members of the multidisciplinary team"
Quote: "all baseline laboratory testing was performed by persons blinded to the subject's intervention status. The examiner who performed postintervention testing was, by protocol design, not familiar with participant and had no knowledge of the participant's baseline scores"
Quote: "the patients, treating physicians and outcomes collectors could not be blinded to the intervention status"
Quote: "outcome assessments were conducted in person at baseline and at 6 and 12 months by trained interviewers not involved in the intervention"
Quote: “Follow-up was done by postal questionnaire, which was sent to all participants every 4 months for 1 year after the fall. Information about subsequent falls, fall-related injury, and details of doctor and hospital visits or admissions and degree of function were requested.”
Quote: "interviewers ... were blinded to the patient’s randomization status and ... were not part of the recruitment or intervention process"
Quote: "the people conducting the measures were blinded to the group assignment"
Quote: "the research nurse involved in reviewing the medical records was blinded to group allocation"
Quote: "interviewer was blind to randomisation"
Quote: "data were processed by a researcher blinded to randomisation and otherwise unconnected with the study"
Quote: "the research nurses who recorded the demographic, clinical, and outcome measures at baseline and after 1 year, remained blind to group allocation"
Quote: "intervention subjects were also asked whether they complied with each HAPSA recommendation"
Comment: The protocol for outcome assessment differed by trial arm, indicating that assessors knew each participant's allocated intervention
Quote: "the interviewer was not blind as to group assignment at the time of the six-month follow-up interview"
Quote: "trained interviewers ... were masked to group assignment and study hypotheses and ... had no role in the intervention"
Quote: "all assessments were done in patients’ homes by one researcher who did not know treatment allocation"
Quote: "The work was done by four to five nurses with the assistance of one full-time and two part-time secretaries."
Quote: “Those assessing the outcomes were blind to group assignment.”
Quote: "independent assessor blinded with respect to subjects' group assignment"
Quote: "interviewers were blinded to the assignment of the subjects"
Quote: "to ensure blinding during data collection, measurements by telephone were contracted to an independent call center (Centre for Data and Information Management, MEMIC), whose operators were unaware of group allocation"
Quote: "the RA [research assistant] remained blinded throughout the study as to each subject’s group assignment"
Quote: "the project coordinator contacted all patients by telephone at three months and six months to collect data"
Quote: "the researcher completed three home visits in a 4-month period (HV1, HV2, and HV3).... During HV3, post-tests were administered to both experimental and comparison subjects"
Quote: "both groups (intervention and control) were assessed by face-to-face interview with an independent researcher"
The authors did not sufficiently describe how they assessed outcomes
Quote: “single-blind”
Care providers, who were not blind to participants' allocated intervention, assessed outcomes
Primary outcomes obtained from hospital records. Secondary outcomes collected through telephone contact
Outcomes obtained through records.
Quote: "two assessors, blinded to group assignment, were responsible for the evaluation of baseline and two follow-up assessments"
Quote: "research assistants who administered the fall risk assessments and conducted the monthly telephone interviews were all blinded to group assignment"
The same person carried out intervention and assessment visits, and protocols were unique to each trial arm
Quote: "the research nurse was blinded to the randomization"
Quote: "trained interviewers, blinded to the purpose of the study and the treatment assignment, obtained baseline (prerandomization) and follow-up outcome assessments at 6 months from the participants"
Quote: "trained interviewers, blinded to the purpose of the study and group assignment, assessed participants at baseline and six months through a structured in-home interview"
Quote: "evaluated by an independent interviewer (a community nurse trained in interviewing techniques and who had no previous connection with the care plan team)"
Quote: "a single assessor (A.N.), who was blinded to participants’ group assignment, carried out all baseline and final testing"
Quote: "the research team was blind to randomisation when reporting problems to the GPs"
Quote: "staff blind to the purpose and design of the study kept an independent record of all deaths, hospital admissions, and admissions to permanent residential care"
Quote: “All reported falls were followed up with a blinded, structured telephone interview to investigate the circumstances and consequences.”
Quote: “Staff at the York Trials Unit inputted questionnaire data, which was checked independently twice for accuracy. Those assessing the outcome of the trial were blinded to group assignment.”
Quote: "research assistants were thus blinded to group assignment"
Quote: "the independent assessor telephoned participants to record the circumstances of the falls and any injuries or resource use as a result of the falls. She remained blind to group allocation"
Quote: "all mortality data came from the Swedish national registration."
Same unblinded case manager providing the intervention made the follow-up assessments at each of seven data points
Quote: "Data were available for the assessments. . .from both HCFA and the Medicare HMOs"
The researchers obtained primary health outcome data from hospital registers.
Questionnaires were mailed to and filled out by participants. No information was provided on blinding status of researchers entering data
Quote: "trained interviewers not involved in the intervention who used a structured interview format"
Comment: Probably done, because outcome data was collected from hospital records or during interviews conducted by independent interviewers
Quote: "trained telephone interviewers independent of the intervention and blinded to the treatment assignment of study subjects collected information on ADL at 3 years"
Quote: "the RNs administering the intervention also measured outcomes; they were not blinded"
Quote: "the subjects were contacted by an interviewer who was blinded to their group assignments"
Quote: "interview was repeated by the independent interviewer after two years"
Quote: "interview was repeated by the independent interviewer after two years"
The outcome assessor was a research assistant not blinded to allocation
Quote: "The same nurse practitioner (MM) evaluated environmental hazards at baseline and immediately after a 12-week, home- based intervention. This individual was blinded to treatment group status, and study participants were reminded not to reveal their treatment assignment during their follow-up visit"
Outcomes self-reported by participants. The authors did not report information on the blinding status of researchers entering data
Questionnaires were mailed to and filled out by participants. No information was provided on blinding status of researchers entering data
Questionnaires were mailed to and filled out by participants. No information was provided on blinding status of researchers entering data
Quote: "the interviews were conducted by trained interviewers, who were unaware of whether a participant had been regularly visited by a nurse or not"
Performance bias due to knowledge of the allocated interventions by participants and personnel during the study
Detection bias due to knowledge of the allocated interventions by outcome assessors
Attrition bias due to amount, nature or handling of incomplete outcome data
Quote: "data collection began with an abstract of the Family Practice Center patient charts for all 198 study participants... Of the 198 participants, 51 died. The interviewers were able to collect information on 143 of the remaining 147 patients" "The in-person interview population included all patients who completed the full battery of questionnaires"
Comment: Some outcome data were collected for 97.3% of living participants, but only 86 of 143 completed the in-person interview.
Data missing for only 1 participant
10.0% of intervention participants compared to 4.7% of control participants self-withdrew from the study. Last observation carried forward (LOCF) used to impute missing data
Comment: Using LOCF may bias estimate in favour of the intervention, as health outcomes tend to deteriorate with time in this population
Quote: "an interaction between time and treatment group ... did not show a systematic difference in the occurrence of missing data over time according to treatment group"
Comment: Missing outcome data balanced in numbers between groups, with similar reasons for missing data between groups
64.7% of intervention participants and 47.0% of control participants withdrew after 2 years. The authors did not report their intention-to-treat procedure.
Rate of and reasons for missing data were similar across groups
10.0% of intervention participants and 13.0% of control participants withdrew from the study. The authors did not report reasons for withdrawal.
The study did not address this outcome, because the authors did not report any relevant outcome data
All randomized participants were included in the analysis
Missing outcome data was <10% and balanced in numbers between groups, with similar reasons for missing data between groups
Quote: “The analyses were by intention to treat.“
Data was missing for only 3.2% in the intervention group and 3.7% in the control group. Authors used two different imputation methods (last observation carried forward and multiple regression) that provided similar results
Quote: "the reasons for attrition varied across groups"
37.5% of intervention participants and 18.5% of control participants were lost to follow-up
Outcome data were available for 95.9% of intervention participants and 100% of control participants
11.3% of intervention participants and 8.4% of control participants were lost to follow-up. Reasons for missing data were similar between groups
12.9% of intervention participants and 7.6% of control participants were lost to follow-up. Reasons for missing data were similar between groups
23.7% of intervention participants and 22.8% of control participants were lost to follow-up, and reasons for missing data differed by group.
Quote: "no one dropped out of the study.... all participants received baseline and six-month interviews to measure the key study variables"
6.9% of intervention participants and 14.5% of control participants were lost at follow-up. Reasons for missing data and intention-to-treat principle were not reported by group
15.3% of intervention participants and 12.9% of control participants were lost at follow-up. Reasons for follow-up were similar between groups
Comment: The authors did not reported attrition or the statistical handling of it post-intervention.
Quote: Tthe imputation method chosen was to replace missing values with a value based on the median change of deterioration (MCD) between baseline and follow-up of all who participated at follow-up. Consequently, the MCD for an outcome measure was added to the individual value registered at baseline and imputed, substituting missing data at follow-up.”
Results included data from all randomised participants who had not died
6.8% of intervention participants and 8.7% of control participants withdrew from study. Reasons for missing data were similar between groups.
25.3% of intervention participants and 19.8% of control participants were lost at follow-up. Reasons for missing data differed between groups
13.1% of participants lost in intervention group, and 16.5% of participants lost in control group. Reasons for missing data differed by group. Only 48 percent of calendars for self-reported falls were returned.
Primary outcome data were available for 95.1% of of participants. Reasons for missing data were similar between groups
Outcome data were available for 94.2% of participants
15.0% of intervention participants and 16.3% of control participants were lost to follow-up. The authors did not provide reasons for missing data
Missing outcome data low and balanced between groups.
Quote: “All analyses were conducted by intention to treat (including participants who refused the intervention)”
The study did not address this item as no relevant outcome data were reported
Primary outcome data available for 98.5% of participants. Reasons for withdrawal for secondary outcome data were similar between groups
Comment: Falls reported in the text do not match Table 5; based on the percentages in Table 5, denominators appear to exclude dropouts.
Quote: “Eighteen patients had died (11 intervention, 7 usual care), 12 had withdrawn (2 intervention, 10 usual care) and 4 were lost to follow up (3 intervention, 1 usual care). There were no significant group differences in mortality or withdrawal rates.”
Reasons for missing data were similar between groups.
Significantly more control participants (23.7%) than intervention participants (11.1%) refused initial baseline assessment and were lost to subsequent follow-ups
No participants were lost to follow-up
Reasons for missing data were similar between groups
16.7% of intervention participants and 15.3% of control participants were lost to follow-up. The authors did not report reasons for missing data by group
Significantly more control participants (14.5%) than intervention participants (3.7%) refused follow-up
Reasons for missing outcome data differed considerably by group, namely for refusing allocated intervention and follow-up evaluation
Outcome data were available for 97.2% of participants.
Reasons for missing outcome data were similar between groups
Insufficient reporting of attrition and reasons for exclusions to permit judgement
Comment: 217 / 238 participants provided full outcome data. It is not clear how means were calculated or the denominator used for dichotomous outcomes. Most outcomes are rounded to nearest whole number.]
Quote: “The primary analysis was performed on an intention to treat (ITT) basis.”
Quote: “Six people died or withdrew without providing any follow-up data; 10 died having provided some follow-up data; three withdrew having provided 1, 3, and 7 months of falls data but did not return follow-up questionnaires; and two were lost to follow-up in Month 12. Attrition at 12 months was 4%, excluding deaths (Figure 1).”
Reasons for missing outcome data were similar between groups
9.9% of intervention participants were lost to follow-up, and 18.5% of control participants were lost to follow-up. Reasons for missing data differed between groups.
Excluded randomised participants from analysis that did not receive the intervention (used n = 196 for intervention group).
67.7% of control participants withdrew, with significantly more withdrawals due to institutionalisation and refusal to continue programme
30% of control partcipants and 28% of intervention participants were lost to follow-up. Methods of imputation were unclear
The authors did not report data for N = 190 participants who were assigned to the intervention but did not receive it.
Quote: "All questionnaires were returned and less than 10% of data was missing"
Reasons for missing data were balanced between groups
Quote: "All analyses were by intention to treat, including subjects who refused intervention."
17.8% of intervention participants and 12.9% of control participants did not provide ADL/IADL data. Intention-to-treat procedure was not reported
The authors analysed data for all randomised participants
Reasons for missing data were balanced between groups
Reasons for missing data were not reported by group
Reasons for missing data were not reported by group
Reasons for missing data were not reported by group
Study had less than 10.0% attrition, and reasons for missing data were similar between groups
Significantly more control participants (6.0%) than intervention participants (0.5%) refused to respond to the final questionnaire
Reasons for missing data were balanced between groups
Quote: "Both “intention-to-treat” (ITT) and per protocol (PP) analyses were performed"
34.7% of intervention participants and 35.0% of control participants lost to follow-up. Intention-to-treat procedure was unclear
Reasons for missing data were balanced between groups
Reporting bias due to selective outcome reporting
Study does not reference a trial protocol
Study does not reference a trial protocol
Study does not reference a trial protocol
Study does not reference a trial protocol
Study does not reference a trial protocol
Outcomes for the exercise group were not fully reported to allow for meta-analysis
Only data at 1 and 18 months were reported, yet measurements were taken at 1, 3, 6, 12 and 18 months
Multiple outcome measures described in the study were either not included in the results section or were reported incompletely to provide for meta-analysis
Quote:"This trial has been registered with clinicaltrials.gov (ID: NCT00465387)" Comment: Secondary outcomes that appear in the study were not specified in the protocol yet appear in the study, making it probable that the authors recorded other outcomes not reported.
Study does not reference a trial protocol.
Study does not reference a trial protocol.
Registration at clinicaltrials.gov. Identifier number is NCT00182962
Study does not reference a trial protocol
Study does not reference a trial protocol
Outcome data were measured at 3, 6, 9 and 12 months but only reported for 12 months
Quote: "The trial was registered with the Australia New Zealand Clinical Trials Register (ID number: 12605000054617)"
Comment: Several outcomes of interest were reported incompletely so that they cannot be entered in a meta-analysis (i.e., Falls Subjective, Functioning ADL/IADL, Health Related QoL, Institutionalisation People)
Study does not reference a trial protocol
Study does not reference a trial protocol
"The only censoring was administrative; all participants’ follow-up was administratively censored at December 31, 2005, corresponding to the last date for which NDI information was available"
Study does not reference a trial protocol
Comment: The authors did not register a trial protcol.
Several outcomes in study protocol are not reported in this paper (
ClinicalTrials.gov NCT00877058), such as falls, fall self-efficacy, and functioning cognitive. Additionally, continuous outcomes (Health-Related QoL and ADL/IADL) only reported as number of people who did not deteriorate.
Physical health, nutritional status, functional status, and socialisation were measured but not reported
Study does not reference a trial protocol
Study does not reference a trial protocol
Study does not reference a trial protocol
The trial ISRCTN is 06813178
Study does not reference a trial protocol
Study does not reference a trial protocol
Study fails to include sufficient information for meta-analysis of relevant outcomes
Comment: Data at Year 1 were not reported for hospitalisation, institutionalisation, and mortality.
Quote: “The study protocol was registered for the UMIN clinical trials registry approved by ICMJE (no. UMIN000001113, April 07, 2008).”
The study report fails to include results for key outcomes that would be expected to have been reported for such a study
Study does not reference a trial protocol
Study does not reference a trial protocol.
Study does not reference a trial protocol
Study does not reference a trial protocol
Outcomes of interest in the review are reported insufficiently for inclusion in a meta-analysis
Study does not reference a trial protocol
Study did not reference a trial protocol
Trial Registration: clinicaltrials.gov identifier: NCT00463658
Outcomes from protocol not reported in study
Study did not reference trial protocol number
Study did not reference trial protocol
Study did not reference trial protocol number
Some outcomes (e.g., quality of Life) were measured and not fully reported
Study does not reference a trial protocol.
Outcome data was collected 6 months but the authors only reported data at 12 months
Study did not reference trial protocol
Do not discuss outcomes found from interview questionnaire. Quote: "the questionnaire functioned as an interview guide as well as an evaluation instrument."
Study did not reference trial protocol
Study did not reference trial protocol
Authors did not adequately report all outcomes (e.g., death) to allow for meta-analysis
Study did not reference trial protocol
Study did not reference trial protocol
Study did not reference trial protocol number
Quote: "Trial registration: Canadian Institutes of Health Research # 10576"
Comment: CIHR utilises the ISRCTN Register. Multiple searches of the registration number and protect keywords did not locate protocol.
Data for some pre-specified measures were not reported
Study did not reference trial protocol
Study did not reference trial protocol
Study did not reference trial protocol
Study did not reference a trial protocol
Study did not reference trial protocol
Study did not reference trial protocol
Study did not reference trial protocol
Study did not reference trial protocol
Bias due to problems not covered elsewhere in the table