Tailored education program using home floor plans for falls prevention in discharged older patients: A pilot randomized controlled trial

Abstract Objective To investigate the effect of a tailored education program using home floor plans on falls prevention in discharged older patients. Design A single-center, parallel, pragmatic, pilot randomized controlled trial with equal allocation to the intervention and control groups. Setting Discharged hospital patients were followed-up in their home settings. Participants All discharged orthopedic patients aged ≥65 years who experienced ≥1 fall(s) in the past year (n = 60). Interventions Both groups received standard care (exercises) and the intervention group also received a tailored education program for falls prevention using home floor plans. Measurements Falls and near-falls at the participants’ homes using a 1-month fall calendar during the 1-month period after discharge. The evaluators were blinded at the baseline assessment. Results Nine participants were withdrawn from the study, leaving 51 of 60 (85%) participants for the final analyses. No falls occurred in the intervention group (n = 25) during follow-up. However, 2 participants (7.7%) fell in the control group (n = 26). Near-falls were reported by 7 participants (28.0%) in the intervention group and 13 participants (50.0%) in the control group. The intervention group had 75% less near-falls compared with the control group, as assessed using a Cox proportional hazards model (hazard ratio, 0.25; 95% confidence interval, 0.09–0.75). Conclusions The tailored education program using home floor plans at the hospital was effective for reducing falls and near-falls among discharged orthopedic patients. Registration of clinical trials: This study was registered with the Research Ethics Committee of University Hospital Medical Information Network (UMIN) Center (000018201).