Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial
Objective To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. Design Pragmatic, randomized-controlled trial. Setting Emergency room, medical outpatient a...
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Public Library of Science
2018
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author | Tan, Pey June Khoo, Ee Ming Chinna, Karuthan Saedon, Nor 'Izzati Zakaria, Mohd Idzwan Ahmad Zahedi, Ahmad Zulkarnain Ramli, Norlina Mohd Khaliddin, Nurliza Mazlan, Mazlina Chee, Kok Han Abidin, Imran Zainal Nalathamby, Nemala Mat, Sumaiyah Jaafar, Mohamad Hasif Khor, Hui Min Khannas, Norfazilah Mohamad Majid, Lokman Abdul Tan, Kit Mun Chin, Ai-Vyrn Kamaruzzaman, Shahrul Bahyah Poi, Philip Jun Hua Morgan, Karen Hill, Keith D. MacKenzie, Lynette Tan, Maw Pin |
author_facet | Tan, Pey June Khoo, Ee Ming Chinna, Karuthan Saedon, Nor 'Izzati Zakaria, Mohd Idzwan Ahmad Zahedi, Ahmad Zulkarnain Ramli, Norlina Mohd Khaliddin, Nurliza Mazlan, Mazlina Chee, Kok Han Abidin, Imran Zainal Nalathamby, Nemala Mat, Sumaiyah Jaafar, Mohamad Hasif Khor, Hui Min Khannas, Norfazilah Mohamad Majid, Lokman Abdul Tan, Kit Mun Chin, Ai-Vyrn Kamaruzzaman, Shahrul Bahyah Poi, Philip Jun Hua Morgan, Karen Hill, Keith D. MacKenzie, Lynette Tan, Maw Pin |
author_sort | Tan, Pey June |
collection | UM |
description | Objective To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. Design Pragmatic, randomized-controlled trial. Setting Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia. Participants Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months. Intervention Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment. Primary and secondary outcome measures The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall. Results Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613–1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846–1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782–1.522)] and mortality rate [RR = 0.896 (95% CI 0.335–2.400)] did not differ between groups. Conclusion Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations. |
first_indexed | 2024-03-06T05:51:29Z |
format | Article |
id | um.eprints-20527 |
institution | Universiti Malaya |
last_indexed | 2024-03-06T05:51:29Z |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | dspace |
spelling | um.eprints-205272019-02-27T03:19:23Z http://eprints.um.edu.my/20527/ Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial Tan, Pey June Khoo, Ee Ming Chinna, Karuthan Saedon, Nor 'Izzati Zakaria, Mohd Idzwan Ahmad Zahedi, Ahmad Zulkarnain Ramli, Norlina Mohd Khaliddin, Nurliza Mazlan, Mazlina Chee, Kok Han Abidin, Imran Zainal Nalathamby, Nemala Mat, Sumaiyah Jaafar, Mohamad Hasif Khor, Hui Min Khannas, Norfazilah Mohamad Majid, Lokman Abdul Tan, Kit Mun Chin, Ai-Vyrn Kamaruzzaman, Shahrul Bahyah Poi, Philip Jun Hua Morgan, Karen Hill, Keith D. MacKenzie, Lynette Tan, Maw Pin R Medicine Objective To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. Design Pragmatic, randomized-controlled trial. Setting Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia. Participants Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months. Intervention Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment. Primary and secondary outcome measures The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall. Results Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613–1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846–1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782–1.522)] and mortality rate [RR = 0.896 (95% CI 0.335–2.400)] did not differ between groups. Conclusion Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations. Public Library of Science 2018 Article PeerReviewed Tan, Pey June and Khoo, Ee Ming and Chinna, Karuthan and Saedon, Nor 'Izzati and Zakaria, Mohd Idzwan and Ahmad Zahedi, Ahmad Zulkarnain and Ramli, Norlina Mohd and Khaliddin, Nurliza and Mazlan, Mazlina and Chee, Kok Han and Abidin, Imran Zainal and Nalathamby, Nemala and Mat, Sumaiyah and Jaafar, Mohamad Hasif and Khor, Hui Min and Khannas, Norfazilah Mohamad and Majid, Lokman Abdul and Tan, Kit Mun and Chin, Ai-Vyrn and Kamaruzzaman, Shahrul Bahyah and Poi, Philip Jun Hua and Morgan, Karen and Hill, Keith D. and MacKenzie, Lynette and Tan, Maw Pin (2018) Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial. PLoS ONE, 13 (8). e0199219. ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0199219 <https://doi.org/10.1371/journal.pone.0199219>. https://doi.org/10.1371/journal.pone.0199219 doi:10.1371/journal.pone.0199219 |
spellingShingle | R Medicine Tan, Pey June Khoo, Ee Ming Chinna, Karuthan Saedon, Nor 'Izzati Zakaria, Mohd Idzwan Ahmad Zahedi, Ahmad Zulkarnain Ramli, Norlina Mohd Khaliddin, Nurliza Mazlan, Mazlina Chee, Kok Han Abidin, Imran Zainal Nalathamby, Nemala Mat, Sumaiyah Jaafar, Mohamad Hasif Khor, Hui Min Khannas, Norfazilah Mohamad Majid, Lokman Abdul Tan, Kit Mun Chin, Ai-Vyrn Kamaruzzaman, Shahrul Bahyah Poi, Philip Jun Hua Morgan, Karen Hill, Keith D. MacKenzie, Lynette Tan, Maw Pin Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial |
title | Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial |
title_full | Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial |
title_fullStr | Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial |
title_full_unstemmed | Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial |
title_short | Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial |
title_sort | individually tailored multifactorial intervention to reduce falls in the malaysian falls assessment and intervention trial myfait a randomized controlled trial |
topic | R Medicine |
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