Overview

Falls are a common and potentially devastating cause of morbidity in older people living in the community. Falls result not only in physical injury, but can potentially reduce independence and impair quality of life. However, falls can be prevented.

CSGPN in collaboration with SSWAHS is now conducting a Modified Otago Falls Prevention Pilot Program. This project will assess the effect of an exercise program, developed specifically for each individual, to reduce their risk of falling and to improve their balance and strength.

The Modified Otago Program will work with participants to implement a home-based, individual exercise plan with the addition of three group based Otago exercise sessions at weeks 2, 4 and 8. These group sessions are intended to increase motivation, improve compliance, and monitor individual progress.

The original Otago Exercise Program has been shown to be highly effective in reducing the risk of falling in older people through individual exercise plans. This program was shown to be most effective in 80+ year olds and reduced falls risk by 35%.

Exercise programs for falls prevention have been shown to be most effective if targeted at older people who have had a recent fall or are at high risk of falling. However, current strategies for recruiting people into community-based exercise programs cannot screen participants for risk. The modified Otago program has been able to identify an effective screening tool to help identify those at risk of suffering a fall by examining the risk factors associated with this.

The aims of this program are to:

• Test whether a modified Otago program can achieve greater participant compliance
• Evaluate a modified Otago program for decreasing falls in a high risk population
• Develop and evaluate referral pathways from primary care providers onto a modified Otago program
• Increase the capacity within SSWAHS and the local community for providing Otago style programs
• Recruit 100 community dwelling people aged 75 years and older with falls risk factors into the project
• To engage selected local fitness providers and train exercise physiologists to deliver a modified Otago program in a group-based setting.

Screening

Screening will involve completing the 75+ Health Assessment for eligible patients. As part of this assessment GPs will be required to also complete the QuickScreen© Falls Risk Assessment (developed by the Prince of Wales Medical Research Institute.)

GPs role

• Screen patients over the age of 75, using the MBS 75+ Health Assessment
• During the assessment screen your patients for falls risk using the QuickScreen Falls Risk Assessment
• Generate management plan (or GPMP if chronic conditions exist)
• Refer eligible patients (with their consent) to the program coordinator.

GP benefits

• 40 RACGP points for referring a minimum of 5 patients and performing a simple audit
• Feedback on your patient’s progress in the program and health outcomes
• Financial reimbursement for your time via the Medicare rebate for the 75+ Health Assessment (MBS item no. 700, 702)
• A free QuickScreen© Falls Risk Assessment package (valued at $300) to assist in the screening process.

Patient benefits

• A comprehensive assessment of their falls risk that provides a risk factor score that correlates with their probability of falling in the next 12 months
• A visit from an exercise physiologist who will assess their abilities and tailor an exercise program to suit their needs
• Three, free group exercise classes in their local community instructed by an exercise physiologist
• Additionally, it is hoped that at the end of the six-month program they will have improved strength, balance and confidence in avoiding falls, as well as a decreased risk of falls.

Target areas

At present, this study is targeting practices in the following areas:
• Belmore
• Campsie
• Lakemba
• Hurlstone Park
• Kingsgrove
• Ashfield
• Croydon
• Summer Hill
• Lewisham
• Petersham

Downloads

• GP information sheet
• Participant information sheet
• Participant referral form to program
• GP referral guide and declaration sheet
• Quickscreen Clinical Falls Risk Assessment Form
• Quickscreen instruction sheet
• 75+ Health Assessment (MBS item no. 700, 702)
• 75+ Health Assessment Fact Sheet
• 75+ Health Assessment Questions and Answers