The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management

David B. Reuben, Priscilla Gazarian, Neil Alexander, Katy Araujo, Dorothy Baker, Jonathan F. Bean, Chad Boult, Peter Charpentier, Pamela Duncan, Nancy Latham, Rosanne M. Leipzig, Lisa M. Quintiliani, Thomas Storer, Siobhan McMahon

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs). The components include a standardized assessment of eight modifiable risk factors (medications; postural hypotension; feet and footwear; vision; vitamin D; osteoporosis; home safety; strength, gait, and balance impairment) and the use of protocols and algorithms to generate recommended management of risk factors; explanation of assessment results to the patient (and caregiver when appropriate) using basic motivational interviewing techniques to elicit patient priorities, preferences, and readiness to participate in treatments; co-creation of individualized falls care plans that patients’ PCPs review, modify, and approve; implementation of the falls care plan; and ongoing monitoring of response, regularly scheduled re-assessments of fall risk, and revisions of the falls care plan. Custom-designed falls care management software facilitates risk factor assessment, the identification of recommended interventions, clinic note generation, and longitudinal care management. The trial testing the effectiveness of the STRIDE intervention is in progress, with results expected in late 2019.

Original languageEnglish (US)
Pages (from-to)2733-2739
Number of pages7
JournalJournal of the American Geriatrics Society
Volume65
Issue number12
DOIs
StatePublished - Dec 2017

Bibliographical note

Funding Information:
Conflict of Interest: Lisa Quintiliani is employed by Boston University and has grant funding from the National Institutes of Health, American Heart Association and American Cancer Society. She has also served as a consultant to the STRIDE study.

Publisher Copyright:
© 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society

Keywords

  • cluster-randomized clinical trial
  • falls
  • injuries
  • prevention

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