Evaluating the evidence for sensor-based technologies and medical devices in fall prevention among hospitalized older adults: A systematic review

Introduction

Falls among hospitalized older adults increase morbidity, prolong hospital stays, and raise healthcare costs. Sensor-based technologies and medical devices are emerging tools for fall prevention, but their clinical effectiveness remains uncertain. This systematic review aimed to assess their effectiveness in reducing inpatient falls, staff workload, and physical restraint use in hospitalized older adults.

Methodology

This review followed PRISMA guidelines and was registered in PROSPERO (CRD42025645616). A comprehensive search of five databases (MEDLINE, EMBASE, CINAHL, Academic Search Complete, Web of Science) and two clinical trial registries (ClinicalTrials.gov, ICTRP) was conducted for RCTs published between January 2000 and January 2025. Eligible studies were RCTs evaluating sensor-based interventions in hospitalized patients aged ≥65 years in acute or rehabilitation settings. The primary outcome was inpatient falls. Secondary outcomes included physical restraint use, staff involvement in fall prevention tasks and healthcare resource utilization. Two reviewers independently screened records in Covidence, resolving conflicts with a third reviewer.

Results

Of 2939 records screened, 10 full-text articles were reviewed, but none met all inclusion criteria. Most were excluded due to unsuitable populations, settings, interventions, or lack of isolated analysis of sensor-based technologies. No RCTs specifically evaluating the standalone impact of such technologies on inpatient fall prevention in older adults were identified.

Discussion

Despite the growing adoption of sensor-based technologies in hospitals, no RCTs have evaluated their isolated clinical effectiveness for fall prevention in older inpatients. High-quality clinical trials are urgently needed to inform evidence-based implementation.