Does the New Fall- and Fracture Prevention Initiative in Oslo Have Effect?

Sponsor
Norwegian Institute of Public Health (Other)
Overall Status
Active, not recruiting
CT.gov ID
NCT05680714
Collaborator
University of Oslo (Other), Oslo University Hospital (Other), Oslo Municipality (Other)
121,000
155

Study Details

Study Description

Brief Summary

The goal of this controlled before and after study is to evaluate a new patient pathway for patients 65 years and older who have suffered a fall injury.

The main questions the study aims to answer are whether this preventive initiative with improved care coordination reduces risk of subsequent hip fractures, admittance to nursing homes or death.

Researchers will compare two boroughs in Oslo who implemented the new patient pathway with the 13 other boroughs who did not reorganize their follow-up, but continued their care as usual.

Condition or Disease Intervention/Treatment Phase
  • Other: Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention

Detailed Description

The study is an evaluation of a new patient follow-up for fall prevention in Oslo with improvement of coordination of care for elderly at risk of fall injuries.

The intervention were introduced to the boroughs of Nordstrand and Østensjø, which are compared to the other 13 boroughs of Oslo in this controlled before and after study.

THE COHORT

All persons 65 years and older in Oslo are included in Oslo Fall Cohort and we follow all cohort participants prospectively.

OUTCOME VARIABLES

  • Hip fracture

  • Long term admittance to nursing home

  • Death

TIMELINE

The investigators have defined the following dates as the start of intervention:
  1. Start of intervention in Nordstrand borough is set to January 1, 2015.

  2. Start of intervention Østensjø borough is set to September 1, 2016.

In the main analysis, fallers from the two intervention boroughs, Nordstrand and Østensjø, will be compared with fallers from the control boroughs during the intervention. Any differences between the intervention and control boroughs before the intervention started will be taken into account.

Data on all participants are available from 2010, and the participants will be followed from January 2012 until December 2019.

For each analysis, persons with a hip fracture or living in a nursing home at baseline will be excluded.

The analysis in the evaluation is based on registry data and no analysis relating the intervention to the outcomes has been done before registration in clinicaltrials.gov.

Study Design

Study Type:
Observational [Patient Registry]
Actual Enrollment :
121000 participants
Observational Model:
Other
Time Perspective:
Prospective
Official Title:
Does the Improved Coordination of Care for Fall- and Fracture Prevention in Oslo Have Effect on the Rate of Hip Fractures, Need of Nursing Homes or Death?
Actual Study Start Date :
Jan 1, 2012
Actual Primary Completion Date :
Dec 31, 2019
Anticipated Study Completion Date :
Dec 1, 2024

Arms and Interventions

Arm Intervention/Treatment
FALLERS IN THE INTERVENTION BOROUGHS

Fallers 65+ years from the borough of Nordstrand from January 1. 2015 Fallers 65+ years from the borough of Østensjø from September 1. 2016 Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

Other: Implement coordination of care with multifactorial falls- and fracture risk assessment and tailored intervention
Other Names:
  • Needs assessment and user involvement
  • Casefinding with identifying high risk individuals
  • Single point of entry to care in the boroughs
  • Cross sectoral plan for follow-up with role clarification
  • Interdisciplinary teams
  • Tools for multifactorial falls and fracture risk assessment (checklists for GP, home visits, injury clinic, osteoporosis)
  • Information sharing
  • Primary and specialist care referral pathways
  • Targeted interventions (Ex: exercise, home safety, osteoporosis treatment, deprescribing, medical assessment)
  • Champions to create enthusiasm and carry the intervention forward
  • Collaborative education of health professionals
  • Technology enablers in the electronic patients records
  • FALLERS IN THE CONTROL BOROUGHS

    Fallers 65+ years from all the 13 other boroughs of Oslo. Fall injury will be included as a time-varying exposure variable. The individuals are all registered as non-fallers until they are registered with a fall injury in the NPR database, when they shift status to fallers.

    NON-FALLERS

    All non-fallers 65+ years from all Oslo boroughs.

    Outcome Measures

    Primary Outcome Measures

    1. Hip fracture [2012-2019]

      A new hip fracture registered in the Norwegian Patient registry

    2. Admission to nursing home [2012-2019]

      Long-term admission to nursing home

    3. Death [2012-2019]

      Total mortality

    Secondary Outcome Measures

    1. Subsequent fall injuries [2012-1019]

      Subsequent falls that result in injuries registered in the Norwegian Patient Registry

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    65 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:
    • 65 years or older

    • Living on Oslo, Norway in the period January 1. 2012 - December 31. 2019

    Exclusion Criteria:
    • Hip fracture before baseline

    • Living in nursing home at baseline

    Contacts and Locations

    Locations

    No locations specified.

    Sponsors and Collaborators

    • Norwegian Institute of Public Health
    • University of Oslo
    • Oslo University Hospital
    • Oslo Municipality

    Investigators

    • Study Director: Gro Idland, PhD, Municipality of Oslo, Department of Health

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Haakon Eduard Meyer, Principal Investigator, Senior Medical Officer, Professor in Epidemiology and Preventive Medicine, Norwegian Institute of Public Health
    ClinicalTrials.gov Identifier:
    NCT05680714
    Other Study ID Numbers:
    • RCN296587
    • 296587
    First Posted:
    Jan 11, 2023
    Last Update Posted:
    Jan 11, 2023
    Last Verified:
    Jan 1, 2023
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Jan 11, 2023