Increasing Communication about Fall Risk and Prevention between Internal Medicine Residents and Older Adults.

Abstract

Objectives: More than one in four older adults fall yearly, but fewer than half inform their doctors. As such, medical trainees must gain experience assessing fall risk in older adults. Studies exploring how often residents initiate these assessments and which interventions effectively increase this frequency are needed. The objective of our study was to determine whether a reminder survey increases the frequency and proportion of resident-initiated fall risk and prevention discussions between Internal Medicine residents and older adults.

Methods: This quantitative pre- and postintervention study used an anonymous survey distributed to residents within one urban Internal Medicine resident clinic. For 1 week, residents were exposed to Stopping Elderly Accidents, Deaths, and Injuries fall risk assessments completed by patients 65 years and older to stimulate fall risk and prevention discussions. Residents completed the same survey 3 months after intervention withdrawal.

Results: Postintervention, there was a statistically significant increase in the proportion of resident-initiated fall risk and prevention discussions (43% vs 81%, P = 0.03). Although not statistically significant, residents reported initiating fall risk (14% vs 19%, P = 1) and fall prevention (3.6% vs 19%, P = 0.25) discussions more frequently, and fewer residents reported forgetfulness as a barrier to having these discussions (57% vs 44%, P = 0.59).

Conclusions: Exposure to the Stopping Elderly Accidents, Deaths, and Injuries fall risk tool is a promising reminder intervention to increase the frequency and proportion of resident-initiated fall risk and prevention discussions; however, larger multisite studies are needed to assess the statistical significance of these findings.