Primary care services lack awareness on falls prevention

There needs to be greater awareness within general practice and other primary health care services about how to prevent falls among seniors, an expert will tell an international conference on aged care and ageing in Sydney on Friday.

In addition to knowing how to treat seniors after a fall, it is important that general practitioners also better understand how to prevent falls, said Professor Lindy Clemson, a professor in ageing and occupational therapy at the University of Sydney.

“We are trying to get the GPs to be aware when their patients are a bit unsteady and ask them the question if they’ve had a fall just to raise that discussion with their patients, so it becomes a routine question,” Professor Clemson told Australian Ageing Agenda ahead of her appearance at this week’s event.

Professor Clemson will discuss her research exploring the implementation of evidence-based fall prevention in primary care, which includes general practice, allied and community health services and community pharmacies, at the conference hosted by the Centre of Excellence in Population Ageing Research at the University of New South Wales on Friday.

The project, which is funded by the Cognitive Decline Partnership Centre, developed an intervention known as the Integrated Solution for Sustainable Fall Prevention (iSOLVE) that helps GPs identify patients who are at risk of falling.

A trial of the intervention, which involved 28 general practices and 560 patients in Sydney, evaluated the effectiveness of changing falls management at general practices.

It found that patients were interested in speaking about falls with their GP, which surprised many doctors and helped shift the focus to prevention, Professor Clemson said.

“Some of the responses that we’ve had from GPs is that they’ve moved from just thinking about treating the injuries to saying ‘there is something I can do to manage these falls,’” she said.

The project is now developing an online training module based on the research findings to assist GPs with how to approach the subject with seniors in the community and to focus on the prevention of falls.

Falls rates coming down

While falls are still a big issue today, Professor Clemson said things have improved from where they were 10 years ago.

“There’s a lot more that we’re doing now and falls rates are coming down. There’s some evidence that we are getting there.

“There’s more understanding out there that falls lead to other things and when people are older and have a fall, that it’s going to make a bigger difference,” Professor Clemson said.

Lower-limb strength training, balance, exercise and medications are among the key factors that can prevent or lead to falls, she said.

“With medications, it depends if people are on certain medications or multiple medications, so having regular medication reviews is really important,” she said.

Professor Clemson said the key message was that the care community can help to prevent falls.

“Falls can be prevented… if GPs and practice nurses think about how they can try talk to their patients about falls, they can do something about it,” Professor Clemson said.

Allied health professionals can also assist by thinking about the different pathways they refer their patients to, she said.

“It’s about trying to identify and reach out to people who are falling now, who we can perhaps make a difference to and reminding GPs that they can have a role in this,” Professor Clemson said.

The 4^th International Conference of Long-term Care Directors and Administrators will take place at the University of NSW in Sydney on 1 – 3 August.

Find out more about Professor Clemson’s research here.

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