Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial)
<h4>Background</h4> <p>Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.</p> <h4>Design</h4> <p>Pragmatic cohort randomised controlled tri...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
Public Library of Science
2017
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| _version_ | 1797054960088645632 |
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| author | Cockayne, S Adamson, J Clarke, A Corbacho, B Fairhurst, C Green, L Hewitt, C Hicks, K Kenan, A Lamb, S McIntosh, C Menz, H Redmond, A Richardson, Z Rodgers, S Vernon, W Watson, J Torgerson, D |
| author2 | Quinn, T |
| author_facet | Quinn, T Cockayne, S Adamson, J Clarke, A Corbacho, B Fairhurst, C Green, L Hewitt, C Hicks, K Kenan, A Lamb, S McIntosh, C Menz, H Redmond, A Richardson, Z Rodgers, S Vernon, W Watson, J Torgerson, D |
| author_sort | Cockayne, S |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.</p> <h4>Design</h4> <p>Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness.</p> <h4>Results</h4> <p>In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained.</p> <h4>Conclusion</h4> <p>There was a small reduction in falls. The intervention may be cost-effective. </p> |
| first_indexed | 2024-03-06T19:04:41Z |
| format | Journal article |
| id | oxford-uuid:14bbd829-ca1b-4eca-b429-ff1ce6a8a4de |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:04:41Z |
| publishDate | 2017 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:14bbd829-ca1b-4eca-b429-ff1ce6a8a4de2022-03-26T10:21:22ZCohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:14bbd829-ca1b-4eca-b429-ff1ce6a8a4deEnglishSymplectic Elements at OxfordPublic Library of Science2017Cockayne, SAdamson, JClarke, ACorbacho, BFairhurst, CGreen, LHewitt, CHicks, KKenan, ALamb, SMcIntosh, CMenz, HRedmond, ARichardson, ZRodgers, SVernon, WWatson, JTorgerson, DQuinn, T <h4>Background</h4> <p>Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.</p> <h4>Design</h4> <p>Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness.</p> <h4>Results</h4> <p>In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained.</p> <h4>Conclusion</h4> <p>There was a small reduction in falls. The intervention may be cost-effective. </p> |
| spellingShingle | Cockayne, S Adamson, J Clarke, A Corbacho, B Fairhurst, C Green, L Hewitt, C Hicks, K Kenan, A Lamb, S McIntosh, C Menz, H Redmond, A Richardson, Z Rodgers, S Vernon, W Watson, J Torgerson, D Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial) |
| title | Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial) |
| title_full | Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial) |
| title_fullStr | Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial) |
| title_full_unstemmed | Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial) |
| title_short | Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial) |
| title_sort | cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people the reform trial |
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