Skip to main content

Preventie van valincidenten

Bij patiënten met een hoog valrisico

Samenvatting

Doel

Beschrijven van de opzet van een studie naar het effect van multidisciplinaire interventie ter preventie van vallen bij ouderen met een hoog valrisico.

Methode

Design: gerandomiseerde trial met economische evaluatie. Deelnemers: recent gevallen, zelfstandigwonende ouderen (≥65 jaar). Na screening op valrisico wordt de hoogrisicogroep blind gerandomiseerd in een interventiegroep (n=100) en gebruikelijke zorggroep (n=100). Interventie: multidisciplinaire evaluatie en behandeling van valrisicofactoren. Follow-up: vallen, valgerelateerde kosten en therapietrouw. Data-analyse: volgens intention-to-treat en per protocol principe.

Discussie

Sterke punten zijn de selectie op valrisico, de transmurale, multidisciplinaire aanpak en de evaluatie van therapietrouw. Een effectieve interventie leidt tot reductie van valincidenten.

This is a preview of subscription content, access via your institution.

literatuur

  1. 1.

    Tinetti ME, Doucette J, Claus E, Marottoli R: Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc. 1995;43:1214-1221.

    Google Scholar 

  2. 2.

    Tromp AM, Pluijm SM,Smit JH, Deeg DJ, Bouter LM, Lips P: Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol. 2001 ;54:837-844.

    Google Scholar 

  3. 3.

    Stel VS, Smit JH, Pluijm SM, Lips P: Consequences of falling in older men and women and risk factors for health service use and functional decline. Age Ageing. 2004;33:58-65.

    Google Scholar 

  4. 4.

    van Haastregt JC, Diederiks JP, van Rossum E, de Witte LP, Voorhoeve PM, Crebolder HF: Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial. BMJ. 2000;321:994-998.

    Google Scholar 

  5. 5.

    Fiatarone MA, O'Neill EF, Ryan ND et al: Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330:1769-1775.

    Google Scholar 

  6. 6.

    Province MA, Hadley EC, Hornbrook MC et al: The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA. 1995;273:1341-1347.

    Google Scholar 

  7. 7.

    Tinetti ME, Baker DI, McAvay G et al: A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;33 1:821-827.

    Google Scholar 

  8. 8.

    Chang JT, Morton SC, Rubenstein LZ et al: Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ. 2004;328:680.

    Google Scholar 

  9. 9.

    Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH: Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2003;CD000340.

  10. 10.

    Richtlijn Preventie van valincidenten bij ouderen. Alphen aan den Rijn: Van Zuiden Communications B.V. Bron: http://www.cbo.nl.

  11. 11.

    Close JC, Hooper R, Glucksman E, Jackson SH, Swift CG: Predictors of falls in a high risk population: results from the prevention of falls in the elderly trial (PROFET). Emerg Med J. 2003;20:421-425.

    Google Scholar 

  12. 12.

    Hendriks MR, Evers SM, Bleijlevens MH, van Haastregt JC, Crebolder HF, van Eijk JT: Cost-effectiveness of a multidisciplinary fall prevention program in community-dwelling elderly people:A randomized controlled trial (ISRCTN 647161 13). Int JTechnol Assess Health Care. 2008;24:193-202.

    Google Scholar 

  13. 13.

    Rizzo JA, Baker DI, McAvay G,Tinetti ME:The cost-effectiveness of a multifactorial targeted prevention program for falls among community elderly persons. Med Care. 1996;34:954-969.

    Google Scholar 

  14. 14.

    Gardner MM, Robertson MC,Campbell AJ: Exercise in preventing falls and fall related injuries in older people:a review of randomised controlled trials. Br J Sports Med. 2000;34:7-17.

    Google Scholar 

  15. 15.

    Pluijm SM, Smit JH,Tromp EA et al: A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporos Int. 2006; 1-9.

  16. 16.

    Mahoney F.I., Barthel D.W.: Functional evaluation: the Barthel Index. Md State Med J. 1965; 14:61-65.

    Google Scholar 

  17. 17.

    Lawton MP, Brody EM:Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179-186.

    Google Scholar 

  18. 18.

    Gandek B,Ware JE,Aaronson NK et al: Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. JClin Epidemiol. 1998;5 1:1171-1 178.

  19. 19.

    Ware J,Jr., Kosinski M, Keller SD:A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220-233.

    Google Scholar 

  20. 20.

    Brooks R: EuroQol:the current state of play. Health Policy. 1996;37:53-72.

    Google Scholar 

  21. 21.

    Guralnik JM, Simonsick EM, Ferrucci L et al: A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.J Gerontol. 1994;49:M85-M94.

    Google Scholar 

  22. 22.

    Duncan PW,Weiner DK, Chandler J, Studenski S: Functional reach: a new clinical measure of balance.J Gerontol. 1990;45:M 192-M197.

    Google Scholar 

  23. 23.

    Rossiter-Fornoff JE, Wolf SL,Wolfson LI, Buchner DM: A cross-sectional validation study of the FICSIT common data base static balance measures. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Gerontol A Biol Sci Med Sci. 1995;50:M291-M297.

    Google Scholar 

  24. 24.

    The prevention of falls in later life.A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. Dan Med Bull. 1987;34 Suppl 4:1-24.

  25. 25.

    Sjosten NM,Salonoja M, Piirtola M et al: A multifactorial fall prevention programme in the community-dwelling aged: predictors of adherence. EurJ Public Health. 2007.

  26. 26.

    Lord SR, Tiedemann A, Chapman K et al: The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial. J Am Geriatr Soc. 2005;53:1296-1304.

    Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Geeske Peeters.

Additional information

onderzoeker in opleiding, VU Medisch Centrum, Amsterdam

internist/klinisch geriater, VU Medisch Centrum, Amsterdam

huisarts en onderzoeker, Huisartsenpraktijk de Grote Rivieren, Amsterdam

epidemioloog, Instituut voor Maatschappelijke Gezondheidszorg, Erasmus MC, Rotterdam

rector Magnificus, Vrije Universiteit, Amsterdam

hoogleraar afdeling Interne geneeskunde, VU Medisch Centrum, Amsterdam

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Peeters, G., de Vries, O., Elders, P. et al. Preventie van valincidenten. TVVG 33, 162–166 (2008). https://doi.org/10.1007/BF03078547

Download citation