Evidence map›Paper›PMID 36469088›Full record

ArticleAge and ageing2022

A realist evaluation of a multifactorial falls prevention programme in care homes.

Paul A Leighton, Janet Darby, Frances Allen, Marie Cook, Rachel Evley, Chris Fox, Maureen Godfrey, Adam Gordon, John Gladman, Jane Horne and 2 more

Abstract read
In one paragraph

Article in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Rethinking the relationship between ambulatory activity and falls in long-term care: risk versus reward.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
    Trial
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Paul A LeightonLifespan and Population Health, School of Medicine (LPH), University of Nottingham, Nottingham UK.ORCID 0000-0001-5208-0274
Janet DarbyInjury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham UK.
Frances AllenInjury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham UK.
Marie CookCollege of Health and Psychology, University of Derby, Derby UK.
Rachel EvleyInjury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham UK.
Chris FoxCollege of Medicine and Health, University of Exeter, Exeter UK.
Maureen GodfreyPublic Contributor.
Adam GordonInjury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham UK.
John GladmanInjury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham UK.
Jane HorneInjury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham UK.
Kate RobertsonNottinghamshire Healthcare NHS Foundation Trust, Nottingham UK.
Pip LoganInjury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham UK.

Funding

Department of Health HTA - 13/115/29
6 · The paper itself

Abstract

backgroundfalls in care homes are common, costly and hard to prevent.Multifactorial falls programmes demonstrate clinical and cost-effectiveness, but the heterogeneity of the care home sector is a barrier to their implementation. A fuller appreciation of the relationship between care home context and falls programme delivery will guide development and support implementation.

methodsthis is a multi-method process evaluation informed by a realist approach.Data include fidelity observations, stakeholder interviews, focus groups, documentary review and falls-rate data. Thematic analysis of qualitative data and descriptive statistics are synthesised to generate care home case studies.

resultsdata were collected in six care homes where a falls programme was trialled. Forty-four interviews and 11 focus groups complemented observations and document review.The impact of the programme varied. Five factors were identified: (i) prior practice and (ii) training may inhibit new ways of working; (iii) some staff may be reluctant to take responsibility for falls; (iv) some may feel that residents living with dementia cannot be prevented from falling; and, (v) changes to management may disturb local innovation.In some care homes, training and improved awareness generated a reduction in falls without formal assessments being carried out.

conclusionsdifferent aspects of the falls programme sparked different mechanisms in different settings, with differing impact upon falls.The evaluation has shown that elements of a multifactorial falls programme can work independently of each other and that it is the local context (and local challenges faced), which should shape how a falls programme is implemented.

Indexed as

Research DesignFocus GroupsHumanscare homesfalls preventionolder peoplequalitative researchrealist evaluation

Identifiers

PMID36469088
PMCPMC9721241

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.