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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 Orcid Logo, Rich Fry Orcid Logo, Ashley Akbari Orcid Logo, Sarah Rodgers, Alan Watkins Orcid Logo, 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 Orcid Logo, Rich Fry Orcid Logo, Ashley Akbari Orcid Logo, Alan Watkins Orcid Logo, 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...

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Published in: Age and Ageing
ISSN: 0002-0729 1468-2834
Published: Oxford University Press (OUP) 2021
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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&amp;Repair Cymru (C&amp;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&amp;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&amp;RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. 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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
author_id_fullname_str_mv 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
container_issue 1
publishDate 2021
institution Swansea University
issn 0002-0729
1468-2834
doi_str_mv 10.1093/ageing/afab201
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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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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