Does the New Fall- and Fracture Prevention Initiative in Oslo Have Effect?

Norwegian Institute of Public Health

Status: Active, not recruiting

Conditions: Fall Injury; Hip Fractures

Treatments: Other: Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention

Study type: Observational

Funder types: Other

Identifiers

NCT05680714

RCN296587

296587 (Other Grant/Funding Number)

Details and patient eligibility

About

The goal of this controlled before and after study is to evaluate a new patient pathway for patients 65 years and older who have suffered a fall injury.

The main questions the study aims to answer are whether this preventive initiative with improved care coordination reduces risk of subsequent hip fractures, admittance to nursing homes or death.

Researchers will compare two boroughs in Oslo who implemented the new patient pathway with the 13 other boroughs who did not reorganize their follow-up, but continued their care as usual.

Full description

The study is an evaluation of a new patient follow-up for fall prevention in Oslo with improvement of coordination of care for elderly at risk of fall injuries.

The intervention were introduced to the boroughs of Nordstrand and Østensjø, which are compared to the other 13 boroughs of Oslo in this controlled before and after study.

THE COHORT

All persons 65 years and older in Oslo are included in Oslo Fall Cohort and we follow all cohort participants prospectively.

OUTCOME VARIABLES

• Hip fracture
• Long term admittance to nursing home
• Death

TIMELINE

The investigators have defined the following dates as the start of intervention:

1. Start of intervention in Nordstrand borough is set to January 1, 2015.
2. Start of intervention Østensjø borough is set to September 1, 2016.

In the main analysis, fallers from the two intervention boroughs, Nordstrand and Østensjø, will be compared with fallers from the control boroughs during the intervention. Any differences between the intervention and control boroughs before the intervention started will be taken into account.

Data on all participants are available from 2010, and the participants will be followed from January 2012 until December 2019.

For each analysis, persons with a hip fracture or living in a nursing home at baseline will be excluded.

The analysis in the evaluation is based on registry data and no analysis relating the intervention to the outcomes has been done before registration in clinicaltrials.gov.

Enrollment: 121,000 patients

Sex: All

Ages: 65+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 65 years or older
• Living on Oslo, Norway in the period January 1. 2012 - December 31. 2019

Exclusion criteria

• Hip fracture before baseline
• Living in nursing home at baseline

Trial design

121,000 participants in 3 patient groups

FALLERS IN THE INTERVENTION BOROUGHS

Description:

Fallers 65+ years from the borough of Nordstrand from January 1. 2015 Fallers 65+ years from the borough of Østensjø from September 1. 2016 Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

Treatment:

Other: Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention

FALLERS IN THE CONTROL BOROUGHS

Description:

Fallers 65+ years from all the 13 other boroughs of Oslo. Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

NON-FALLERS

Description:

All non-fallers 65+ years from all Oslo boroughs.