Does the New Fall- and Fracture Prevention Initiative in Oslo Have Effect?

NCT05680714 | Unknown

• 2 other identifiers: RCN296587296587
• Study Type: observational
• Target: 121,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this controlled before and after study is to evaluate a new patient pathway for patients 65 years and older who have suffered a fall injury. The main questions the study aims to answer are whether this preventive initiative with improved care coordination reduces risk of subsequent hip fractures, admittance to nursing homes or death. Researchers will compare two boroughs in Oslo who implemented the new patient pathway with the 13 other boroughs who did not reorganize their follow-up, but continued their care as usual.

Conditions

Fall Injury; Hip Fractures

Outcome Measures

Primary Outcomes (3)

• Hip fracture

  A new hip fracture registered in the Norwegian Patient registry

  2012-2019

• Admission to nursing home

  Long-term admission to nursing home

  2012-2019

• Death

  Total mortality

  2012-2019

Secondary Outcomes (1)

• Subsequent fall injuries

  2012-1019

Study Arms (3)

FALLERS IN THE INTERVENTION BOROUGHS

Fallers 65+ years from the borough of Nordstrand from January 1. 2015 Fallers 65+ years from the borough of Østensjø from September 1. 2016 Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

Other: Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention

FALLERS IN THE CONTROL BOROUGHS

Fallers 65+ years from all the 13 other boroughs of Oslo. Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

NON-FALLERS

All non-fallers 65+ years from all Oslo boroughs.

Interventions

Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention OTHER

Also known as: Needs assessment and user involvement, Casefinding with identifying high risk individuals, Single point of entry to care in the boroughs, Cross sectoral plan for follow-up with role clarification, Interdisciplinary teams, Tools for multifactorial falls and fracture risk assessment (checklists for GP, home visits, injury clinic, osteoporosis), Information sharing, Primary and specialist care referral pathways, Targeted interventions (Ex: exercise, home safety, osteoporosis treatment, deprescribing, medical assessment), Champions to create enthusiasm and carry the intervention forward, Collaborative education of health professionals, Technology enablers in the electronic patients records

FALLERS IN THE INTERVENTION BOROUGHS

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Total population in Oslo 65 years or older in the period 2012 - 2019.

You may qualify if:

• years or older
• Living on Oslo, Norway in the period January 1. 2012 - December 31. 2019

You may not qualify if:

• Hip fracture before baseline
• Living in nursing home at baseline

Sponsors & Collaborators

• Norwegian Institute of Public Health: lead
• University of Oslo: collaborator
• Oslo University Hospital: collaborator
• Oslo Municipality: collaborator

MeSH Terms

Conditions

Hip Fractures

Interventions

Needs Assessment; Patient Care Team; Checklist; House Calls; Deprescriptions

Condition Hierarchy (Ancestors)

Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries

Intervention Hierarchy (Ancestors)

Health Services Research; Health Planning; Health Care Economics and Organizations; Delivery of Health Care; Health Care Quality, Access, and Evaluation; Patient Care Management; Health Services Administration; Data Collection; Health Care Evaluation Mechanisms; Quality of Health Care; Professional Practice; Organization and Administration; Drug Therapy; Therapeutics

Study Officials

• Gro Idland, PhD

  Municipality of Oslo, Department of Health

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Target Duration: 8 Years
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Senior Medical Officer, Professor in Epidemiology and Preventive Medicine

Study Record Dates

• First Submitted: December 13, 2022
• First Posted: January 11, 2023
• Study Start: January 1, 2012
• Primary Completion: December 31, 2019
• Study Completion: December 1, 2024
• Last Updated: January 11, 2023

Record last verified: 2023-01

Data Sharing

• IPD Sharing: Will not share