USPSTF Recommendations for Falls Prevention

The United States
Preventative Services Task Force just released a final recommendation about
falls prevention strategies in the
primary care setting. It’s interesting reading: http://www.uspreventiveservicestaskforce.org/uspstf11/fallsprevention/fallsprevrs.htm

Key take-home points
include:

• The USPSTF recommends exercise
  or physical therapy and vitamin D supplementation to prevent falls in
  community-dwelling adults aged 65 years or older who are at increased risk for
  falls (B Recommendation).
• More specifically…
• There is high certainty that exercise
  or physical therapy has moderate net benefit in preventing falls in older
  adults
• There is moderate certainty that
  vitamin D supplementation has moderate net benefit in preventing falls in older
  adults (with meta-analysis showing a number needed to treat of 10 to prevent one fall) 

• No single recommended tool or
  brief approach can reliably identify older adults at increased risk for falls,
  but several reasonable and feasible approaches are available for primary care
  clinicians. See the Clinical Considerations section for additional information
  on risk assessment. 

• The USPSTF does not recommend
  automatically performing an in-depth multifactorial risk assessment in
  conjunction with comprehensive management of identified risks to prevent falls
  in community-dwelling adults aged 65 years or older because the likelihood of
  benefit is small. In determining whether this service is appropriate in
  individual cases, patients and clinicians should consider the balance of
  benefits and harms on the basis of the circumstances of prior falls, comorbid
  medical conditions, and patient values (C Recommendation).
• There is moderate certainty that
  multifactorial risk assessment with comprehensive management of identified
  risks has a small net benefit in preventing falls in older adults

Keep in mind that these recommendations apply to
screening and prevention for
the general population of adults age 65 and older in ambulatory care, and
may need to be tailored to the
kinds of high-risk patients that are often seen in geriatrics and palliative care practice.

by: Mike Steinman