Fall Risk Identification and Management for Older Veterans
ConditionFall Risk
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age65+
SponsorVA Office of Research and Development
About this trial
Falls are a common occurrence among older adults, and Veterans have an even higher risk of falling compared to non-Veterans. These falls often lead to severe health consequences, including traumatic brain injuries, hip fractures, emergency visits, hospitalizations, and even death. It is crucial to prioritize fall prevention in order to reduce injuries and enable older Veterans to age comfortably at home. Although current fall prevention programs in the Veterans Health Administration primarily focus on inpatient care and nursing homes, there is a pressing need to address falls among older Veterans living independently in the community. The proposed VA-specific Fall Risk Identification and Management (FRIM) model aims to proactively prevent falls in older Veterans who receive primary care, effectively reducing the occurrence of adverse health events associated with falls. By placing emphasis on prevention rather than reacting after falls have already happened, this initiative seeks to significantly enhance the overall well-being of older Veterans.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Receives care within GeriPACT, or general PACT as needed (Aim 1); Receives care within general PACT (standard VHA primary care) (Aim 2)
Screens positive for increased fall risk (answers "yes" to any of 3 screening questions)
Positive screen on at least two fall risk factor assessments (Aim 1); Positive screen on at least one fall risk factor assessment (Aim 2)
Access to telehealth
Disqualifiers
Life expectancy <12 months, as determined by PCP
Neurological diagnosis (e.g., cerebral vascular accident, multiple sclerosis, Parkinson's Disease)
Moderate cognitive impairment (<13 on telephone Montreal Cognitive Assessment (MoCA-BLIND) or <18 on MoCA Full administered during clinic visit in the previous 3 months)
Unstable condition that precludes safe participation in structured exercise (e.g., recent deep vein thrombosis) if expected fall risk factor is physical, as determined by PCP or chart review
Trial design
Design model
Parallel
Treatments tested in this trial
Strengthening (Physical Therapy, Gerofit)
Other interventionIndividuals with physical fall risk will be referred to strengthening interventions available within the VHA. These may include Physical Therapy or Gerofit (a supervised exercise program).
Medication Reconciliation (Clinical Pharmacology)
Other interventionIndividuals with pharmacological fall risk will be referred to clinical pharmacology for medication reconciliation. This includes examining the current medication list and deprescribing medications, if appropriate.
Home Safety Modification (Occupational Therapy)
Other interventionIndividuals with environmental fall risk will be referred to occupational therapy for home safety assessments and modifications. This will involve modifying components within the home to reduce potential fall risk factors.
Treatment groups
108 Participants
are divided into 2 treatment groupsGroup A: Fall Risk Identification and Management ModelExperimental treatment 3 interventions
Group B: Standard of careNo intervention 0 interventions
Trial outcomes
Primary outcomes
1
Participant recruitment
Participant recruitment will be tracked as part of feasibility. It will be determined as the proportion of Veterans screened as eligible that are recruited.
Time frame
Program start2
Participant retention
Participant retention will be tracked as part of feasibility. It will be determined as the 1-year retention rate of participants.
Time frame
Program start - 1 year post baselineSecondary outcomes
1
Fall risk identification burden
Fall risk identification burden will be tracked as part of feasibility. It will be determined as the time to identify fall risk factors during telehealth visit.
Time frame
Program start, Program end (average of 12 weeks)2
Fall risk management burden
Fall risk management burden will be tracked as part of feasibility. It will be determined as the time to complete fall risk factor management.
Time frame
Program start - Program end (average of 12 weeks)3
Theoretical framework of acceptability questionnaire
Acceptability will be measured using an established questionnaire based on the theoretical framework of acceptability. Responses on the questionnaire range from 1 (did not like, high burden) to 5 (strongly liked, low burden).
Time frame
Program end (average of 12 weeks)4
3 key questions
The 3 key questions include 1) whether the older adult feels unsteady when standing or walking, 2) worries about falling, 3) or has fallen in the past year. Participant responses of 'yes' or 'no' to each question will be recorded.
Time frame
Program startSponsors and contacts
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Source ClinicalTrials.gov