Application of a falls prevention program for older people to primary health care practice

Background. Our research group has established the effectiveness of an individually tailored home exercise program to prevent falls and fall injuries in older people in four controlled trials. In one of these trials we evaluated the applicability of the exercise program to routine primary health care practice and the feasibility of nurses implementing the program. Methods. People aged 80 years and older, registered with general practices in three exercise (n = 330 participants) and four control centers (n = 120 participants) in New Zealand, were invited to take part by their doctor. We investigated program reach, uptake, and compliance. We carried out physical assessments at baseline and after 1 year to assess the impact of the program. Results. Most (85%) doctors agreed to take part and they approved 71% of patients to undertake the exercise program. Overall 47%, of people invited agreed to participate and 70% of the exercise participants remained exercising at 1 year. Balance score and chair stand time improved by a similar amount in each exercise center compared with the control centers. Conclusions. This falls prevention program is acceptable to older people and their doctors. Nurses trained by a physiotherapist can deliver the home exercise program effectively in routine primary health care practice. (C) 2002 American Health Foundation and Elsevier Science (USA).