Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial).
<h4>Background</h4>Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.<h4>Design</h4>Pragmatic cohort randomised controlled trial in England and Ireland. 1010...
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Public Library of Science (PLoS)
2017-01-01
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| author | Sarah Cockayne Joy Adamson Arabella Clarke Belen Corbacho Caroline Fairhurst Lorraine Green Catherine E Hewitt Kate Hicks Anne-Maree Kenan Sarah E Lamb Caroline McIntosh Hylton B Menz Anthony C Redmond Zoe Richardson Sara Rodgers Wesley Vernon Judith Watson David J Torgerson REFORM study |
| author_facet | Sarah Cockayne Joy Adamson Arabella Clarke Belen Corbacho Caroline Fairhurst Lorraine Green Catherine E Hewitt Kate Hicks Anne-Maree Kenan Sarah E Lamb Caroline McIntosh Hylton B Menz Anthony C Redmond Zoe Richardson Sara Rodgers Wesley Vernon Judith Watson David J Torgerson REFORM study |
| author_sort | Sarah Cockayne |
| collection | DOAJ |
| description | <h4>Background</h4>Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.<h4>Design</h4>Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness.<h4>Results</h4>In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained.<h4>Conclusion</h4>There was a small reduction in falls. The intervention may be cost-effective.<h4>Trial registration</h4>ISRCTN ISRCTN68240461. |
| format | Article |
| id | doaj-art-24491eceead948bd894d72efa108bcd3 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-24491eceead948bd894d72efa108bcd32025-08-20T02:31:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01121e016871210.1371/journal.pone.0168712Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial).Sarah CockayneJoy AdamsonArabella ClarkeBelen CorbachoCaroline FairhurstLorraine GreenCatherine E HewittKate HicksAnne-Maree KenanSarah E LambCaroline McIntoshHylton B MenzAnthony C RedmondZoe RichardsonSara RodgersWesley VernonJudith WatsonDavid J TorgersonREFORM study<h4>Background</h4>Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.<h4>Design</h4>Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness.<h4>Results</h4>In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained.<h4>Conclusion</h4>There was a small reduction in falls. The intervention may be cost-effective.<h4>Trial registration</h4>ISRCTN ISRCTN68240461.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168712&type=printable |
| spellingShingle | Sarah Cockayne Joy Adamson Arabella Clarke Belen Corbacho Caroline Fairhurst Lorraine Green Catherine E Hewitt Kate Hicks Anne-Maree Kenan Sarah E Lamb Caroline McIntosh Hylton B Menz Anthony C Redmond Zoe Richardson Sara Rodgers Wesley Vernon Judith Watson David J Torgerson REFORM study Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial). PLoS ONE |
| title | Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial). |
| title_full | Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial). |
| title_fullStr | Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial). |
| title_full_unstemmed | Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial). |
| title_short | Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial). |
| title_sort | cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people the reform trial |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168712&type=printable |
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