A national survey of services for bone health and falls prevention exercise programmes in primary care in Ireland

Abstract

BACKGROUND: In order to develop the necessary falls and fracture prevention strategies a review of current services is required. METHODS: All 32 Primary Care Local Health Offices (LHO) in Ireland were surveyed. AIMS: To profile physiotherapy-led bone health and falls prevention services operating within the primary care structure in Ireland. RESULTS: Seventy nine per cent (n = 23) of LHOs had at least one programme operating managed in all cases by senior physiotherapists. Falls prevention programmes (72%) were most prevalent while (35%) of programmes targeted bone health. General Practitioners (87.5%) were the most common referral source and prior fall the principal referral reason. A majority of programme participants were in the 70–80 year age range. Exercise components reflected clinical guidelines, focusing on balance and strength training. Interventions were modelled on the Otago (50%), Later Life Training / FaME (29%) programmes. The absence of client follow-up post programme for measurement of falls or fracture incidence or health service utilisation was notable. Barriers to programme development included inappropriate venues, lack of patient transport, financial and staffing restraints. CONCLUSIONS: Most LHOs provided some form of evidence-based programme however it is unlikely that current service levels meet population needs. Barriers to service expansion were identified.