evidence/gaps
Cochrane · systematic review · CD005465

Interventions for preventing falls in older people in care facilities and hospitals

Cameron, ID, Dyer, SM, Panagoda, CE, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
28
current version
GRADE rated
26
No studies
2
Included studies
NR
No studies 2 · 7.1%Ungraded 0 · 0%Very low 19 · 67.9%Low 5 · 17.9%Moderate 2 · 7.1%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Summary of findings: Exercise compared with usual care in care facilities

Population: and
4 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of falls Length of
Summary of findings: Exercise vs usual care
no estimate extracted10 studies · 2002 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, publication bias
Risk of falling Length of
Summary of findings: Exercise vs usual care
RR 1.02 [0.88, 1.18]10 studies · 2090 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, publication bias
Risk of fracture Length of
Summary of findings: Exercise vs usual care
RR 0.88 [0.25, 3.14]1 study · 183 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, publication bias
Adverse events Length of
Summary of findings: Exercise vs usual care
no estimate extracted4 studies · 1032 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, publication bias

Summary of findings: General medication review compared with usual care in care facilities

Population: and
4 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of falls Length of
Summary of findings: General medication review vs usual care
no estimate extracted6 studies · 2409 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias
Risk of falling Length of
Summary of findings: General medication review vs usual care
RR 0.93 [0.8, 1.09]6 studies · 5139 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias
Risk of fracture Length of
Summary of findings: General medication review vs usual care
RR 1.6 [0.28, 9.16]1 study · 93 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias
Adverse events Length of
Summary of findings: General medication review vs usual care
RR 1.07 [0.23, 5.01]1 study · 93 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias

Summary of findings: Vitamin D supplementation in care facilities

Population: and
4 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of falls Length of
no estimate extracted4 studies · 4512 participantsModerate
Downgraded: risk of bias, imprecision, publication bias
Risk of falling Length of
RR 0.92 [0.76, 1.12]4 studies · 4512 participantsModerate
Downgraded: risk of bias, imprecision, publication bias
Risk of fracture Length of
RR 1.09 [0.58, 2.03]3 studies · 4464 participantsVery low
Downgraded: risk of bias, imprecision, publication bias
Adverse events Length of
RR 4.84 [0.24, 98.9]2 studies · 747 participantsVery low
Downgraded: risk of bias, imprecision, publication bias

Summary of findings: Multifactorial interventions compared with usual care in care facilities

Population: and
4 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of falls Length of
Summary of findings: Multifactorial interventions vs usual care
no estimate extracted10 studies · 3439 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Risk of falling Length of
Summary of findings: Multifactorial interventions vs usual care
RR 0.92 [0.81, 1.05]9 studies · 3153 participantsLow
Downgraded: risk of bias, imprecision, inconsistency
Risk of fracture Length of
Summary of findings: Multifactorial interventions vs usual care
RR 0.79 [0.3, 2.07]5 studies · 2160 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency
Adverse events Length of
Summary of findings: Multifactorial interventions vs usual care
no estimate extracted3 studies · 312 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency

Summary of findings: Additional exercise plus physiotherapy compared with usual physiotherapy in hospitals

Population: and
4 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of falls Length of
Summary of findings: Additional exercise plus physiotherapy vs usual physiotherapy
no estimate extracted2 studies · 215 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Risk of falling Length of
Summary of findings: Additional exercise plus physiotherapy vs usual physiotherapy
RR 0.36 [0.14, 0.93]2 studies · 83 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Risk of fracture
Summary of findings: Additional exercise plus physiotherapy vs usual physiotherapy
no estimate extractedNRNo studies
Adverse events Length of
Summary of findings: Additional exercise plus physiotherapy vs usual physiotherapy
no estimate extracted1 study · 161 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Summary of findings: Bed alarms compared with usual care in hospitals

Population: and
4 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of falls Length of
Summary of findings: Bed alarms vs usual care
no estimate extracted2 studies · 28649 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Risk of falling Length of
Summary of findings: Bed alarms vs usual care
RR 0.93 [0.38, 2.24]2 studies · 28649 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Risk of fracture
Summary of findings: Bed alarms vs usual care
no estimate extractedNRNo studies
Adverse events Length of
Summary of findings: Bed alarms vs usual care
no estimate extracted2 studies · 27742 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Summary of findings: Multifactorial interventions compared with usual care in hospitals

Population: and
4 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of falls Length of
Summary of findings: Multifactorial interventions vs usual care
no estimate extracted5 studies · 44664 participantsLow
Downgraded: risk of bias, imprecision
Risk of falling Length of
Summary of findings: Multifactorial interventions vs usual care
RR 0.82 [0.62, 1.09]3 studies · 39889 participantsVery low
Downgraded: risk of bias, imprecision
Risk of fracture Length of
Summary of findings: Multifactorial interventions vs usual care
RR 0.76 [0.14, 4.1]2 studies · 4615 participantsVery low
Downgraded: risk of bias, imprecision
Adverse events Length of
Summary of findings: Multifactorial interventions vs usual care
no estimate extracted4 studies · 39763 participantsVery low
Downgraded: risk of bias, imprecision