Falls among older general practice patients: risk factors and fall prevention in Belgium, 2019-2020

Abstract

Abstract Background Around 30% of people aged 65 years and older living in the community fall every year. Falling among older persons is a multifactorial health condition needing multifactorial care. General practitioners (GPs) are well placed to implement a multifactorial management. Therefore a surveillance study of accidental falls was carried out to study characteristics of falls, fallers and fall risks; prevalence of risk factors and fall prevention by GPs. Methods A 2-year retrospective population-based study based on data collected by the Belgian network of Sentinel General Practices (SGP) on all community-dwelling patients aged ≥65 years consulting their GP for new fall-related injuries. Data of 2019-20 were pooled because of no significant difference. Factors associated with a multifactorial risk profile were analyzed by multivariate logistic regression. Results During 2019-20, 759 accidental falls were registered. For 24% of fallers, medical and/or nursing intervention was required and 22% had a severe injury. During consult, 31% was referred to the hospital. 59% of patients showed at least one of the four most prevalent fall risks, i.e. deficits of mobility or balance, polypharmacy, cognitive impairment or psychotropic medication. A multifactorial risk profile was observed in 46% of patients and was associated with age, recurrent falling, falling in residential care center and during activities of daily living. Addressing surrounding and walking problems were most taken as preventive measures. For 28% of fallers, other healthcare providers (mainly nurse and physiotherapist) were involved in preventive care. Conclusions This study yields recent data on risk factors and preventive fall interventions in general practice in Belgium. Collaborative preventive fall measures are taken in about one in four patients, although previous SGP research (2009-10) showed that interventions were better implemented when specialized caregivers had been involved concurrently. Key messages Multifactorial interventions are crucial for preventing accidental falls in older general practice patients in Belgium. More collaboration between GPs and other caregivers is needed when taking preventive fall measures.