Outcomes of importance to people with multiple sclerosis, Parkinson’s disease and stroke following a falls prevention intervention: a qualitative study to inform a core outcome set

Abstract

Purpose: Falls are a major issue for people with neurological conditions, and the evaluation of falls prevention interventions is of high priority. To date, the views of patient groups regarding outcomes of importance have been largely overlooked. The purpose of this study was to explore outcomes of interest among people with Multiple Sclerosis (MS), Parkinson’s disease (PD) and stroke upon completion of falls prevention interventions to inform the development of a core outcome set (COS).

Materials and methods: Five online focus groups and one semi-structured interview were conducted among people with PD (n = 10), MS (n = 7), and post-stroke (n = 3), one of whom also had PD. Transcripts were analysed using reflexive thematic analysis.

Results: Four themes were developed; (1) Fall events are not homogeneous, (2) Exercise-based programmes are beneficial but falls services are not meeting user needs, (3) Programme success beyond the reduction in falls, and (4) Acquisition of skills to self-manage falls beyond the life of the programme.

Conclusions: This study presents new perspectives across patient groups regarding important outcomes upon completion of falls prevention interventions. Taken together with the findings of a literature review, this data will inform the development of a COS.

Implications for rehabilitation

• People with multiple sclerosis, Parkinson’s disease and stroke consider the success of a falls prevention intervention to be dependent on improvements across a wide range of outcomes.

• The design and implementation of falls prevention interventions should align with patient preferences.

• Clinicians and researchers should consider the use of multidomain interventions to facilitate improvements in the desired outcomes of patients.

Keywords:

• Parkinson’s disease
• multiple sclerosis
• stroke
• qualitative study
• falls
• core outcome set

Acknowledgements

We gratefully acknowledge the contribution of the PPI panel who provided very valuable feedback on the aims and objectives, design, and methods of this study. The authors would like to express their special thanks and appreciation to the participants for their time and engagement, and to the gatekeepers for their help during the recruitment phase.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data are not openly available to maintain the anonymity of all participants in this study. Please contact the corresponding author with any future requests regarding the dataset.

Additional information

Funding

This work was supported by the Irish Research Council; Nicola O’Malley is a postgraduate scholar funded by the Irish Research Council through the Government of Ireland Postgraduate Scholarship Programme under award number GOIPG/2018/3379. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.