Effects of case management based on preventing falls in older people: A systematic review.

Abstract

Falls among older adults can lead to negative consequences with physical, functional, social, and psychological functioning, and a high prevalence of mortality. However, it is still unclear whether case management can reduce the number of falls in this population. The aims of this review were to analyze the effects of case management on preventing falls and reducing risk factors for falls in older people. A systematic review was conducted, searching for and synthesizing clinical trials involving case management in older people who had falls or risk for fall outcomes. Two authors extracted data using predefined data fields, and risk of bias was assessed by the Physiotherapy Evidence Database (PEDro) scale. Twelve studies were included in the final review. Case management in older people did not significantly reduce the number of falls, falls per person, or severity of falls compared to control groups. Adherence to recommendations in case management ranged from 25% to 88%. There is limited evidence of reduced rates of falls and specific risk factors for falls among people who received case management interventions. Randomized trials with good quality are needed.