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Theme: Person-Centred Care
This review was led by the Evidence Synthesis Team.
Falls are an increasing problem, affecting a third of people aged 65 and over each year. The estimated number of hip fractures worldwide will rise from 1.66 million in 1990 to 6.26 million in 2050, even if age-adjusted incidence rates remain stable. High quality evidence for preventing falls is available in the form of meta-analyses, randomised controlled trials and clinical guidelines; however, this evidence has not necessarily been transferred into changes in clinical practice. As such, falls and fall-related injuries continue to escalate with a less than optimal provision of evidence-based healthcare.
One aspect of this problem originates from the lack of understanding on how best to implement the evidence-base into clinical practice, particularly where the routine practice may be very different to the experimental conditions observed in the original research. In practice clinicians and patients may be required to change their behaviour and adopt new practices, and organisations may be required to develop different or new systems of working across professional and organisational boundaries. This is challenging for all when the interventions are complex and multi-faceted.
Two systematic reviews were undertaken in this area to help understand why research evidence has often not been translated into changes in clinical practice. The team completed a systematic review and synthesis of qualitative research studies in order to identify what factors serve as barriers and facilitators to the successful implementation of falls prevention programmes from the perspectives of both older people and healthcare professionals (review 1). They also looked at the quantitative evidence and summarise the most effective methods of implementing evidence based falls prevention for community-dwelling older adults (review 2).