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Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017
Joe Hollinghurst,
Helen Daniels 
,
Rich Fry ,
Ashley Akbari ,
Sarah Rodgers,
Alan Watkins ,
Sarah Hillcoat-Nalletamby,
Neil Williams,
Silviya Nikolova,
David Meads,
Andy Clegg
,
Rich Fry ,
Ashley Akbari ,
Sarah Rodgers,
Alan Watkins ,
Sarah Hillcoat-Nalletamby,
Neil Williams,
Silviya Nikolova,
David Meads,
Andy Clegg
Age and Ageing, Volume: 51, Issue: 1
Swansea University Authors:
Joe Hollinghurst, Helen Daniels , Rich Fry , Ashley Akbari , Alan Watkins , Sarah Hillcoat-Nalletamby
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DOI (Published version): 10.1093/ageing/afab201
Abstract
Backgroundfalls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.Aimdetermine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood o...
| Published in: | Age and Ageing |
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| ISSN: | 0002-0729 1468-2834 |
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Oxford University Press (OUP)
2021
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<?xml version="1.0"?><rfc1807><datestamp>2022-08-16T11:42:09.5452573</datestamp><bib-version>v2</bib-version><id>58465</id><entry>2021-10-27</entry><title>Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017</title><swanseaauthors><author><sid>d7c51b69270b644a11b904629fe56ab0</sid><firstname>Joe</firstname><surname>Hollinghurst</surname><name>Joe Hollinghurst</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>a054902cb884be2476d0f097f0016294</sid><ORCID>0000-0001-8899-0333</ORCID><firstname>Helen</firstname><surname>Daniels</surname><name>Helen Daniels</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>d499b898d447b62c81b2c122598870e0</sid><ORCID>0000-0002-7968-6679</ORCID><firstname>Rich</firstname><surname>Fry</surname><name>Rich Fry</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>81fc05c9333d9df41b041157437bcc2f</sid><ORCID>0000-0003-3804-1943</ORCID><firstname>Alan</firstname><surname>Watkins</surname><name>Alan Watkins</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>3bd6b771d306dc371504d375e37f4b86</sid><firstname>Sarah</firstname><surname>Hillcoat-Nalletamby</surname><name>Sarah Hillcoat-Nalletamby</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-10-27</date><deptcode>FGMHL</deptcode><abstract>Backgroundfalls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.Aimdetermine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls.Study Designretrospective longitudinal controlled non-randomised intervention cohort study.Settingour cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service.Methodswe created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression.Resultscompared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%).ConclusionsC&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance.</abstract><type>Journal Article</type><journal>Age and Ageing</journal><volume>51</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Oxford University Press (OUP)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0002-0729</issnPrint><issnElectronic>1468-2834</issnElectronic><keywords>older people, falls prevention, frailty, falls</keywords><publishedDay>18</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-10-18</publishedDate><doi>10.1093/ageing/afab201</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>BHF_/British Heart Foundation/United Kingdom;
HCRW_SCF-18-1504/HCRW/HCRW_/United Kingdom;
WT_/Wellcome Trust/United Kingdom;
CSO_/Chief Scientist Office/United Kingdom;
HCRW_HRG-16-1325/HCRW/HCRW_/United Kingdom;
HCRW_SCG-19-1654/HCRW/HCRW_/United Kingdom;
MRC_/Medical Research Council/United Kingdom;
BEHA/41/DMT_/The Dunhill Medical Trust/United Kingdom</funders><projectreference/><lastEdited>2022-08-16T11:42:09.5452573</lastEdited><Created>2021-10-27T00:55:14.7514834</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Joe</firstname><surname>Hollinghurst</surname><order>1</order></author><author><firstname>Helen</firstname><surname>Daniels</surname><orcid>0000-0001-8899-0333</orcid><order>2</order></author><author><firstname>Rich</firstname><surname>Fry</surname><orcid>0000-0002-7968-6679</orcid><order>3</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>4</order></author><author><firstname>Sarah</firstname><surname>Rodgers</surname><order>5</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>6</order></author><author><firstname>Sarah</firstname><surname>Hillcoat-Nalletamby</surname><order>7</order></author><author><firstname>Neil</firstname><surname>Williams</surname><order>8</order></author><author><firstname>Silviya</firstname><surname>Nikolova</surname><order>9</order></author><author><firstname>David</firstname><surname>Meads</surname><order>10</order></author><author><firstname>Andy</firstname><surname>Clegg</surname><order>11</order></author></authors><documents><document><filename>58465__21583__6204cd7b4aaf470bbeda2e8a82045582.pdf</filename><originalFilename>58465.pdf</originalFilename><uploaded>2021-11-18T16:23:09.4410234</uploaded><type>Output</type><contentLength>636200</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© The Author(s) 2021. This is an Open Access article distributed under the terms of the Creative Commons Attribution License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
| spelling |
2022-08-16T11:42:09.5452573 v2 58465 2021-10-27 Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 d7c51b69270b644a11b904629fe56ab0 Joe Hollinghurst Joe Hollinghurst true false a054902cb884be2476d0f097f0016294 0000-0001-8899-0333 Helen Daniels Helen Daniels true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 3bd6b771d306dc371504d375e37f4b86 Sarah Hillcoat-Nalletamby Sarah Hillcoat-Nalletamby true false 2021-10-27 FGMHL Backgroundfalls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.Aimdetermine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls.Study Designretrospective longitudinal controlled non-randomised intervention cohort study.Settingour cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service.Methodswe created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression.Resultscompared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%).ConclusionsC&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance. Journal Article Age and Ageing 51 1 Oxford University Press (OUP) 0002-0729 1468-2834 older people, falls prevention, frailty, falls 18 10 2021 2021-10-18 10.1093/ageing/afab201 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University BHF_/British Heart Foundation/United Kingdom; HCRW_SCF-18-1504/HCRW/HCRW_/United Kingdom; WT_/Wellcome Trust/United Kingdom; CSO_/Chief Scientist Office/United Kingdom; HCRW_HRG-16-1325/HCRW/HCRW_/United Kingdom; HCRW_SCG-19-1654/HCRW/HCRW_/United Kingdom; MRC_/Medical Research Council/United Kingdom; BEHA/41/DMT_/The Dunhill Medical Trust/United Kingdom 2022-08-16T11:42:09.5452573 2021-10-27T00:55:14.7514834 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Joe Hollinghurst 1 Helen Daniels 0000-0001-8899-0333 2 Rich Fry 0000-0002-7968-6679 3 Ashley Akbari 0000-0003-0814-0801 4 Sarah Rodgers 5 Alan Watkins 0000-0003-3804-1943 6 Sarah Hillcoat-Nalletamby 7 Neil Williams 8 Silviya Nikolova 9 David Meads 10 Andy Clegg 11 58465__21583__6204cd7b4aaf470bbeda2e8a82045582.pdf 58465.pdf 2021-11-18T16:23:09.4410234 Output 636200 application/pdf Version of Record true © The Author(s) 2021. This is an Open Access article distributed under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/ |
| title |
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 |
| spellingShingle |
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 Joe Hollinghurst Helen Daniels Rich Fry Ashley Akbari Alan Watkins Sarah Hillcoat-Nalletamby |
| title_short |
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 |
| title_full |
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 |
| title_fullStr |
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 |
| title_full_unstemmed |
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 |
| title_sort |
Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017 |
| author_id_str_mv |
d7c51b69270b644a11b904629fe56ab0 a054902cb884be2476d0f097f0016294 d499b898d447b62c81b2c122598870e0 aa1b025ec0243f708bb5eb0a93d6fb52 81fc05c9333d9df41b041157437bcc2f 3bd6b771d306dc371504d375e37f4b86 |
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d7c51b69270b644a11b904629fe56ab0_***_Joe Hollinghurst a054902cb884be2476d0f097f0016294_***_Helen Daniels d499b898d447b62c81b2c122598870e0_***_Rich Fry aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari 81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins 3bd6b771d306dc371504d375e37f4b86_***_Sarah Hillcoat-Nalletamby |
| author |
Joe Hollinghurst Helen Daniels Rich Fry Ashley Akbari Alan Watkins Sarah Hillcoat-Nalletamby |
| author2 |
Joe Hollinghurst Helen Daniels Rich Fry Ashley Akbari Sarah Rodgers Alan Watkins Sarah Hillcoat-Nalletamby Neil Williams Silviya Nikolova David Meads Andy Clegg |
| format |
Journal article |
| container_title |
Age and Ageing |
| container_volume |
51 |
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1 |
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2021 |
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Swansea University |
| issn |
0002-0729 1468-2834 |
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10.1093/ageing/afab201 |
| publisher |
Oxford University Press (OUP) |
| college_str |
Faculty of Medicine, Health and Life Sciences |
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|
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facultyofmedicinehealthandlifesciences |
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Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
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Faculty of Medicine, Health and Life Sciences |
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Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
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| description |
Backgroundfalls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.Aimdetermine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls.Study Designretrospective longitudinal controlled non-randomised intervention cohort study.Settingour cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service.Methodswe created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression.Resultscompared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%).ConclusionsC&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance. |
| published_date |
2021-10-18T04:15:01Z |
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1763754011592228864 |
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11.037166 |