Evidence map›Paper›PMID 37993405›Full record

SynthesisAge and ageing2023

Critical features of multifactorial interventions for effective falls reduction in residential aged care: a systematic review, intervention component analysis and qualitative comparative analysis.

Jenni Suen, Dylan Kneale, Katy Sutcliffe, Wing Kwok, Ian D Cameron, Maria Crotty, Catherine Sherrington, Suzanne Dyer

Open access · hybridAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Age and ageing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 4 pooled it
13.1field-weighted citation impact, top 1% of its field
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

8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Interventions for preventing falls in older people in care facilities.The Cochrane database of systematic reviews · 2025
    Pooled it
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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

8 authors at 4 institutions in 2 countries.

Jenni SuenRehabilitation, Aged and Extended Care, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University of South Australia, Bedford Park, Australia.
Dylan KnealeEPPI Centre, UCL Social Research Institute, University College London, London WC1H 0NS, United Kingdom.
Katy SutcliffeEPPI Centre, UCL Social Research Institute, University College London, London WC1H 0NS, United Kingdom.
Wing KwokInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia.
Ian D CameronJohn Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District and the University of Sydney, St Leonards, Australia.
Maria CrottyRehabilitation, Aged and Extended Care, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University of South Australia, Bedford Park, Australia.
Catherine SherringtonInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia.
Suzanne DyerRehabilitation, Aged and Extended Care, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University of South Australia, Bedford Park, Australia.
Flinders University · AUSydney Local Health District · AUUniversity College London · GBNorthern Sydney Local Health District · AU

Funding

Medical Research Council
6 · The paper itself

Abstract

backgroundMultifactorial fall prevention trials providing interventions based on individual risk factors have variable success in aged care facilities. To determine configurations of trial features that reduce falls, intervention component analysis (ICA) and qualitative comparative analysis (QCA) were undertaken.

methodsRandomised controlled trials (RCTs) from a Cochrane Collaboration review (Cameron, 2018) with meta-analysis data, plus trials identified in a systematic search update to December 2021 were included. Meta-analyses were updated. A theory developed through ICA of English publications of trialist's perspectives was assessed through QCA and a subgroup meta-analysis.

resultsPooled effectiveness of multifactorial interventions indicated a falls rate ratio of 0.85 (95% confidence interval, CI, 0.65-1.10; I2 = 85%; 11 trials). All tested interventions targeted both environmental and personal risk factors by including assessment of environmental hazards, a medical or medication review and exercise intervention. ICA emphasised the importance of co-design involving facility staff and managers and tailored intervention delivery to resident's intrinsic factors for successful outcomes. QCA of facility engagement plus tailored delivery was consistent with greater reduction in falls, supported by high consistency (0.91) and coverage (0.85). An associated subgroup meta-analysis demonstrated strong falls reduction without heterogeneity (rate ratio 0.61, 95%CI 0.54-0.69, I2 = 0%; 7 trials).

conclusionMultifactorial falls prevention interventions should engage aged care staff and managers to implement strategies which include tailored intervention delivery according to each resident's intrinsic factors. Such approaches are consistently associated with a successful reduction in falls, as demonstrated by QCA and subgroup meta-analyses. Co-design approaches may also enhance intervention success.

Indexed as

Accidental FallsAgedHomes for the AgedHumansRandomized Controlled Trials as Topicaged carefacility engagementfall preventionmultifactorialolder peoplesystematic review

Identifiers

PMID37993405
PMCPMC10665139
OpenAlexW4388923590

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.