Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis
Background: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. Methods: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prev...
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doaj-0fba4721ae0e4fc5b472ab9ef9d1e88f2020-11-24T22:01:09ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012018-03-0115349810.3390/ijerph15030498ijerph15030498Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-AnalysisPeixia Cheng0Liheng Tan1Peishan Ning2Li Li3Yuyan Gao4Yue Wu5David C. Schwebel6Haitao Chu7Huaiqiong Yin8Guoqing Hu9Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, ChinaDepartment of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, ChinaDepartment of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, ChinaDepartment of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, ChinaDepartment of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, ChinaDepartment of Environmental and Occupational Health, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, ChinaDepartment of Psychology, University of Alabama, Birmingham, AL 35294, USADivision of Biostatistics, The University of Minnesota, Minneapolis, MN 55455, USACentral South University Library, 172 Tongzipo Rd., Changsha 410013, ChinaDepartment of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, ChinaBackground: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. Methods: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prevent falls in community-dwelling adults aged 60 and over. Combined odds ratio (OR) and 95% credible interval (95% CrI) were calculated. Results: A total of 49 trials involving 27,740 participants and 9271 fallers were included. Compared to usual care, multifactorial interventions (MFI) demonstrated the greatest efficacy (OR: 0.64, 95% CrI: 0.53 to 0.77) followed by interventions combining education and exercise (EDU + EXC) (OR: 0.65, 95% CrI: 0.38 to 1.00) and interventions combining exercise and hazard assessment and modification (EXC + HAM) (OR: 0.66, 95% CrI: 0.40 to 1.04). The effect of medical care performed the worst (OR: 1.02, 95% CrI: 0.78 to 1.34). Model fit was good, inconsistency was low, and publication bias was considered absent. The overall quality of included trials was high. The pooled odds ratios and ranking probabilities remained relatively stable across all sensitivity analyses. Conclusions: MFI and exercise appear to be effective to reduce falls among older adults, and should be considered first as service delivery options. Further investigation is necessary to verify effectiveness and suitableness of the strategies to at-risk populations.http://www.mdpi.com/1660-4601/15/3/498fallselderlypreventionnetwork meta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Peixia Cheng Liheng Tan Peishan Ning Li Li Yuyan Gao Yue Wu David C. Schwebel Haitao Chu Huaiqiong Yin Guoqing Hu |
spellingShingle |
Peixia Cheng Liheng Tan Peishan Ning Li Li Yuyan Gao Yue Wu David C. Schwebel Haitao Chu Huaiqiong Yin Guoqing Hu Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis International Journal of Environmental Research and Public Health falls elderly prevention network meta-analysis |
author_facet |
Peixia Cheng Liheng Tan Peishan Ning Li Li Yuyan Gao Yue Wu David C. Schwebel Haitao Chu Huaiqiong Yin Guoqing Hu |
author_sort |
Peixia Cheng |
title |
Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis |
title_short |
Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis |
title_full |
Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis |
title_fullStr |
Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis |
title_full_unstemmed |
Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis |
title_sort |
comparative effectiveness of published interventions for elderly fall prevention: a systematic review and network meta-analysis |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2018-03-01 |
description |
Background: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. Methods: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prevent falls in community-dwelling adults aged 60 and over. Combined odds ratio (OR) and 95% credible interval (95% CrI) were calculated. Results: A total of 49 trials involving 27,740 participants and 9271 fallers were included. Compared to usual care, multifactorial interventions (MFI) demonstrated the greatest efficacy (OR: 0.64, 95% CrI: 0.53 to 0.77) followed by interventions combining education and exercise (EDU + EXC) (OR: 0.65, 95% CrI: 0.38 to 1.00) and interventions combining exercise and hazard assessment and modification (EXC + HAM) (OR: 0.66, 95% CrI: 0.40 to 1.04). The effect of medical care performed the worst (OR: 1.02, 95% CrI: 0.78 to 1.34). Model fit was good, inconsistency was low, and publication bias was considered absent. The overall quality of included trials was high. The pooled odds ratios and ranking probabilities remained relatively stable across all sensitivity analyses. Conclusions: MFI and exercise appear to be effective to reduce falls among older adults, and should be considered first as service delivery options. Further investigation is necessary to verify effectiveness and suitableness of the strategies to at-risk populations. |
topic |
falls elderly prevention network meta-analysis |
url |
http://www.mdpi.com/1660-4601/15/3/498 |
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