Effectiveness of non-pharmaceutical interventions to prevent falls and fall-related fractures in older people living in residential aged care facilities – a systematic review and network meta-analysis protocol

Abstract

Background: Preventing falls and fractures from falls in residents of aged care facilities are an eminent public health goal. Evidence on the effectiveness of non-pharmaceutical methods to prevent falls and fall-related fractures in residential aged care facilities (RACFs) is unclear. This review aims to assess and rank the effectiveness of the most common fall- and fracture prevention strategies of non-pharmaceutical nature in RACFs.

Method: This systematic review with network-meta-analysis follows the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P). We will conduct the systematic literature search across the medical databases MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL). We will conduct pairwise meta-analyses with a random effects model. When appropriate, we will construct a network graph and conduct network meta-analyses within a Bayesian framework for all outcomes and interventions. Bayesian network meta-analysis (random effects models) will be used to compare the relative effectiveness of the different interventions under investigation.

Conclusion: Our review should provide a broader picture of the evidence of benefits and harms of exercise and other non-pharmaceutical interventions in fall- and fracture prevention in residents of residential aged care facilities (RACFs). Findings will benefit public and individual health by contributing in the beneficence of multidisciplinary care of institutionalized seniors through optimization of fall- and fracture prevention programs.

Registration: Protocol registration: PROSPERO 2018 CRD42018116446; Registration on 28 November 2018.

Keywords:

• Elderly
• fracture prevention
• falls prevention
• network meta-analysis

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Michiel Twiss

Michiel Twiss (B. Pt) is a clinician and is self-employed physiotherapist. He has a degree in Clinical Expertise in Geriatric Physiotherapy.

Roger Hilfiker

Roger Hilfiker (MSc PT, OMT) is a lecturer and researcher at the School of Health Sciences, Physiotherapy, Leukerbad (Switzerland). Roger teaches the topic of systematic reviews and meta-analyses and publishes public health relevant topics. He is in the final stages of his Ph.D.

Timo Hinrichs

Timo Hinrichs (Physician, Dr. habil.) is the Deputy Head of Department Rehabilitative and Regenerative Sports Medicine at the University Basel, Switzerland. His research interests include the epidemiology of aging, activity promotion in primary care practice, geriatric assessment, and recording mobility and physical activity using portable sensors.

Eling D. de Bruin

Eling D. de Bruin (Ph.D Human Movement Science, B. Pt) Professor of physiotherapy at the Karolisnka Institutet in Stockholm, Sweden. Eling research focus is on the intimately linked motor and cognitive aspects of human movement and age-related risk of falling.

Slavko Rogan

Slavko Rogan (Ph.D, MA adult education, MA school management, MSc PT, MSc Osteopathy) is a researcher and lecturer at Department of Health, BFH, Switzerland and is currently studying in a PhD programme at VUB. His topic: effectiveness of guided self-study in bachelor physiotherapy students: Heutagogy – academic physiotherapy education.