Fall prevention programs in emergency departments improve safety for seniors after discharge

Falls are one of the most common reasons older adults are treated in the emergency department, and many patients are discharged home the same day. That transition can be a vulnerable moment, especially if the factors that led to the fall aren't fully addressed. A new study suggests that emergency departments may be able to take meaningful steps during visits to help older adults stay safer once they return home.

The findings come from the GAPcare II trial, "Emergency Department Visit Outcomes of a Multicenter Randomized Trial of a Fall Prevention Intervention," which was published in Academic Emergency Medicine. Researchers evaluated whether a fall prevention program could be delivered during emergency department visits to adults aged 65 and older, within seven days of an accidental fall, who were expected to be discharged and were without mobility-limiting injuries. The intervention paired 852 patients with physical therapists to assess balance and mobility and pharmacists to review medications that may increase fall risk.

Researchers found that these consultations were feasible to complete during the emergency visit and yielded individualized recommendations, including mobility aids, medication adjustments, and referrals for follow-up care. Patients received bedside pharmacy and physical therapy consultations. Pharmacists recommended changing medication timing (26%), stopping fall risk medications (19%), and dose adjustments (18%). Physical therapists recommended assistive devices (66%), outpatient services (36%), and skilled nursing facility admission (25%).

"A fall is often a signal that something in a person's health or environment needs attention," said Sarah D. Berry, MD, MPH, senior scientist at Hebrew SeniorLife's Hinda and Arthur Marcus Institute for Aging Research and chief of the Division of Gerontology at Beth Israel Deaconess Medical Center. "This study shows that emergency departments can go beyond treating the immediate injury and help identify factors that may lead to future falls, giving patients and caregivers a plan to prevent future falls as they return home."

While the research focused on how well the program could be implemented rather than long-term outcomes, it highlights the emergency department as a potential point of intervention to support safer recovery after discharge.