In Balans: the (cost-)effectiveness of a fall prevention intervention on falls and fall injuries in community-dwelling older adults with an increased risk of falls.
Description: In Balans is een 14-weeks valpreventieprogramma voor ouderen. Eerder onderzoek uit 2006 liet zien dat ouderen in een verzorgingshuis door In Balans minder vielen. In dit project onderzoeken we het effect van een aangepaste versie van In Balans op het aantal vallen, het aantal valletsels en de maatschappelijke kosten bij thuiswonende ouderen met een verhoogd valrisico, in vergelijking met algemene beweegadviezen. We zullen 256 ouderen in het onderzoek includeren. Gedurende een jaar lang wordt het aantal vallen, letsels, medische kosten, maar ook spierkracht, balans, dagelijkse hoeveelheid activiteit, mate van valangst, ervaren gezondheid en kwaliteit van leven vergeleken tussen de trainings- en controlegroep. De uitkomsten van dit onderzoek bieden de mogelijkheid om weloverwogen te beslissen of In Balans een zinvolle bijdrage levert aan optimale valpreventie bij thuiswonende ouderen, en hoe het programma in dat geval het beste in de praktijk geïmplementeerd kan worden.\n\nApplication summary: RELEVANCE – Falls and fall related injuries in our ageing population are a serious threat to life expectancy, quality of life and healthcare costs. Several fall prevention programmes (some with strong evidence for effectiveness) are available in the Netherlands, yet all use different approaches and aim at a different target groups. ‘In Balans’ is a 14-week, low-cost group intervention, that is widely used for a specific target population of pre-frail older adults with an increased risk of falling. The current status of effectiveness of ‘In Balans’ is ‘theoretically well described’, based on one positive effectiveness study in frail and pre-frail elderly living in nursing homes, who showed a strong reduction (61%) in risk of becoming a faller in the pre-frail older adults only. Now it is time to fill the knowledge gap on the (cost-)effectiveness of ‘In Balans’ in its current form, for an extended target group (pre-frail as well as non-frail individuals with an increased fall risk) in its current form. This will serve health care professionals, policy makers and financiers in timely and effective prevention of falls. OBJECTIVE - To assess the (cost-)effectiveness of the falls prevention intervention ‘In Balans’ in community-dwelling older persons with an increased risk of falls, as compared to general exercise recommendations. STRATEGY - We will perform a single-blinded, multicenter cluster randomized controlled trial (RCT) in 256 non- and pre-frail older adults with an increased risk of falls, with stratified randomization at the patient level, over 12 months of follow-up. Primary outcome is the number of falls (with and without injury), monitored over 12 months by a fall calender and monthly phone calls. As secondary outcomes, we will evaluate the cost-effectiveness of ‘In Balans’ as compared to general exercise recommendations from a societal perspective, and the short- and long-term effects on physical performance, physical activity and perceived health and quality of life. Measurements will be performed at baseline (M0), immediately after the intervention (M4) and 12 months after after baseline (M12). Linear mixed-model analyses will be performed according to the intention-to-treat principle on the whole study population; with subgroup analyses to identify possible differences in intervention effects between non-frail and pre-frail respondents. An increase in physical activity is considered an important secondary outcome, but will also be used for secondary analyses to evaluate the effect of an increase in exposure on the number of falls. IMPLEMENTATION - Based on the results and the process evaluation, we will develop a detailed implementation plan to ensure actual implementation of the project’s results as well as further dissemination. VeiligheidNL plays a main role as partner in the implementation and with their Nationwide network for fall prevention optimal dissemination is ensured.\n\nKeywords: [{"boost": 1, "value": "valpreventie"}, {"boost": 1, "value": "ouderen"}, {"boost": 1, "value": "effectiviteit"}]
Funder: ZonMw
Funding type: research
Funder scheme: ["Effectiviteitsonderzoek"]
Start date: 2020-09-01
End date: 2025-02-28
Investigator: prof. dr. M. Pijnappels PhD
Institution: Vrije Universiteit Amsterdam
Funded outputs count: 0
Funder award ID: zonmw-555002018-25728
OpenAlex ID: G1304448236