The University of Texas Medical Branch at Galveston will join nine other clinical health system sites nationwide to conduct a clinical trial in which individually tailored interventions for preventing fall-related injuries will be tested. The trial will integrate proven fall-reduction strategies into a cohesive intervention that many health care systems will be able to adopt. The study seeks new ways to address the personal and public health burden of falls, suffered by 1 out of 3 adults over 65 each year. These falls cause injuries which, in turn, may lead to health decline, loss of independence, or even death.
“The patient-centered outcomes approach exemplifies this project’s efforts to go beyond the norms to solve a very important health issue,” said Dr. Elena Volpi, the principal investigator for UTMB and interim director of UTMB’s Sealy Center on Aging. “The issue is complex and requires a thoughtful and complex array of solutions. This initiative shows great promise for truly improving the lives of those most at risk for falls.”
The trial will be sponsored by the National Institute on Aging and funded by the Patient-Centered Outcomes Research Institute, as part of the Falls Injuries Prevention Partnership and is expected to cost approximately $30 million over the five-year project. First-year funding of $7.6 million was awarded on June 1st.
Although risk factors for falls and fall-related injuries have been analyzed in previous studies, along with preventive interventions, the best evidence for how to reduce falls has not been widely applied yet. Conventional medical education, as well as other methods, have been used in an attempt to change physician behavior about falls, but hasn’t been very effective due to a lack of engagement by patients and other stakeholders.
“With this trial, we will be able to evaluate interventions on a comprehensive and very large scale,” said NIA director Dr. Richard J. Hodes. “This study will focus on people at increased risk for injuries from falls, the specific care plans that should be implemented, including interventions tailored to individual patients, and how physicians and others in health care and in the community can be involved.”
Several hundred individuals 75 or older with one or more modifiable risk factors for falls will be enrolled by the UTMB-led research team. After having his or her risk of falling assessed, each person will then receive the current standard of care, including information on how to prevent falls, or the experimental study intervention, which consists of developing and administering individualized care plans. These plans will be reviewed, modified, and approved by the participant’s primary care physician and will include proven fall-risk reduction interventions that can be implemented by the research team, physicians, and other health care providers, caregivers and community-based organizations. The novelty of this intervention centers on the concept of a falls care manager, who will be working with each participant’s primary care provider in order to develop the plans and monitor success.
A total of ten trial sites have been chosen across the country in order to address geographic, rural/urban, academic/nonacademic, and racial/ethnic diversity, as well as to include a range of health care systems and models of care. The 14 NIA-funded Claude D. Pepper Older Americans Independence Centers will participate in the study by helping to develop the trial and the protocol. These include the nation’s most important research programs in complex geriatric syndromes, among which UTMB is one.
UTMB will work with the following other trial sites: Essentia Health, Duluth, Minn.; HealthCare Partners, Torrance, Calif.; Johns Hopkins Medicine, Baltimore, Md.; Mount Sinai Health System, New York; Partners HealthCare, Waltham, Mass.; Reliant Medical Group, Worcester, Mass.; University of Iowa Health Alliance, Iowa City, Iowa; University of Pittsburgh Medical Center, Pittsburgh, Pa.; University of Michigan, Ann Arbor, Mich.