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Manuel Montero‐Odasso, Manuel Montero-Odasso, Nellie Kamkar, Frederico Pieruccini‐Faria, Abdelhady Osman, Yanina Sarquis‐Adamson, Jacqueline Close, David B. Hogan, Susan Winifred Hunter, Rose Anne Kenny and 102 more
Importance: With the global population aging, falls and fall-related injuries are ubiquitous, and several clinical practice guidelines for falls prevention and management for individuals 60 years or older have been developed. A systematic evaluation of the recommendations and agreement level is lacking. Objectives: To perform a systematic review of clinical practice guidelines for falls prevention and management for adults 60 years or older in all settings (eg, community, acute care, and nursing homes), evaluate agreement in recommendations, and identify potential gaps. Evidence Review: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses statement methods for clinical practice guidelines on fall prevention and management for older adults was conducted (updated July 1, 2021) using MEDLINE, PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, PEDro, and Epistemonikos databases. Medical Subject Headings search terms were related to falls, clinical practice guidelines, management and prevention, and older adults, with no restrictions on date, language, or setting for inclusion. Three independent reviewers selected records for full-text examination if they followed evidence- and consensus-based processes and assessed the quality of the guidelines using Appraisal of Guidelines for Research & Evaluation II (AGREE-II) criteria. The strength of the recommendations was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation scores, and agreement across topic areas was assessed using the Fleiss κ statistic. Findings: Of 11 414 records identified, 159 were fully reviewed and assessed for eligibility, and 15 were included. All 15 selected guidelines had high-quality AGREE-II total scores (mean [SD], 80.1% [5.6%]), although individual quality domain scores for clinical applicability (mean [SD], 63.4% [11.4%]) and stakeholder (clinicians, patients, or caregivers) involvement (mean [SD], 76.3% [9.0%]) were lower. A total of 198 recommendations covering 16 topic areas in 15 guidelines were identified after screening 4767 abstracts that proceeded to 159 full texts. Most (≥11) guidelines strongly recommended performing risk stratification, assessment tests for gait and balance, fracture and osteoporosis management, multifactorial interventions, medication review, exercise promotion, environment modification, vision and footwear correction, referral to physiotherapy, and cardiovascular interventions. The strengths of the recommendations were inconsistent for vitamin D supplementation, addressing cognitive factors, and falls prevention education. Recommendations on use of hip protectors and digital technology or wearables were often missing. None of the examined guidelines included a patient or caregiver panel in their deliberations. Conclusions and Relevance: This systematic review found that current clinical practice guidelines on fall prevention and management for older adults showed a high degree of agreement in several areas in which strong recommendations were made, whereas other topic areas did not achieve this level of consensus or coverage. Future guidelines should address clinical applicability of their recommendations and include perspectives of patients and other stakeholders.
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Montero‐Odasso, M., Montero-Odasso, M., Kamkar, N., Pieruccini‐Faria, F., Osman, A., Sarquis‐Adamson, Y., Close, J., Hogan, D. B., Hunter, S. W., Kenny, R. A., Lipsitz, L. A., Lord, S. R., Madden, K. M., Petrović, M., Ryg, J., Speechley, M., Tan, M. P., Tan, M. P., Velde, N. V. D., … Kobusingye, O. C. (2021). Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults. JAMA Network Open, 4(12), e2138911. https://doi.org/10.1001/jamanetworkopen.2021.38911
Montero‐Odasso, Manuel, et al. "Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults." JAMA Network Open, vol. 4, no. 12, 2021, pp. e2138911, https://doi.org/10.1001/jamanetworkopen.2021.38911.
Montero‐Odasso, Manuel, Manuel Montero-Odasso, Nellie Kamkar, Frederico Pieruccini‐Faria, Abdelhady Osman, Yanina Sarquis‐Adamson, Jacqueline Close, et al. "Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults." JAMA Network Open 4, no. 12 (2021): e2138911. https://doi.org/10.1001/jamanetworkopen.2021.38911.
Montero‐Odasso M., Montero-Odasso M., Kamkar N. [и др.] Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults // JAMA Network Open. — 2021. — Vol. 4, № 12. — P. e2138911. — URL: https://doi.org/10.1001/jamanetworkopen.2021.38911
@article{monteroodasso2021evaluation,
title = {{Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults}},
author = {Manuel Montero‐Odasso and Manuel Montero-Odasso and Nellie Kamkar and Frederico Pieruccini‐Faria and Abdelhady Osman and Yanina Sarquis‐Adamson and Jacqueline Close and David B. Hogan and Susan Winifred Hunter and Rose Anne Kenny and Lewis Arnold Lipsitz and Stephen R. Lord and Kenneth Michael Madden and Mirko Petrović and Jesper Ryg and Mark Speechley and Maw Pin Tan and Maw Pin Tan and Nathalie van der Velde and Joe Verghese and Tahir Masud and Task Force on Global Guidelines for Falls in Older Adults and Mirko Petrović and Alice Nieuwboer and Ellen Vlaeyen and Koen Milisen and Jesper Ryg and Rose Anne Kenny and Robert Bourke and Sirpa A. Hartikainen and Tischa J. M. van der Cammen and Nathalie van der Velde and Tahir Masud and Chris J. Todd and Finbarr C. Martin and David Marsh and Sallie Lamb and James Frith and Pip Logan and Dawn Ann Skelton and Hubert Blain and Cedric Anweiller and Ellen Freiberger and Clemens Becker and Matteo Cesari and Alvaro Casas-Herrero and Javier Perez Jara and Christina Alonzo Bouzòn and Anna‐Karin Welmer and Stephanie Birnghebuam and Reto Werner Kressig and Manuel Montero-Odasso and Manuel Montero-Odasso and Mark Speechley and Bill McIlroy and Susan Hunter and Richard M. Camicioli and Kenneth Madden and Mireille Norris and Jennifer Watt and Louise Mallet and David B. Hogan and Joe Verghese and Ervin Sejdić and Luigi Ferrucci and Lewis Arnold Lipsitz and David A. Ganz and Neil B. Alexander and Fabiana Giber and Marcelo Carlos Schapira and Ricardo Jauregui and Felipe Melgar Cuellar and Daniela Cristina Carvalho de Abreu and Roberto Alves Lourenço and Monica Pierrucini and Alejandro Ceriani and Pedro Marín-Larraín and Homero Gac Espinola and José Fernando Gómez-Montes and Carlos Alberto Cano-Gutierrez and Xinia Ramirez Ulate and José Ernesto Picado Ovares and Patricio Gabriel Buendia and Susana Lucia Tito and Diego Martínez Padilla and Sara G. Aguilar-Navarro and Alberto Avila-Funes and Rogelio Moctezum and José Alberto Ávila‐Funes and Luis Miguel Gutiérrez‐Robledo and Luis Manuel Cornejo Alemán and Edgar Aguilera Caona and Juan Carlos Carbajal and Jose Francisco Parodi and Aldo Sgaravatti and STEPHEN LORD and Catherine Sherrington and Cathy Said and Ian Douglas Cameron and Meg Morris and Gustavo Duque and Jacqueline Close and Ngaire M Kerse and Maw Pin Tan and Leilei Duan and Ryota Sakurai and Chang Won Won and Hossein Negahban and Chang Won Won and Jeffrey M. Hausdorff and Sebastiana Kalula and Olive Chifefe Kobusingye},
journal = {JAMA Network Open},
year = {2021},
volume = {4},
number = {12},
pages = {e2138911},
doi = {10.1001/jamanetworkopen.2021.38911},
url = {https://doi.org/10.1001/jamanetworkopen.2021.38911}
}TY - JOUR AU - Montero‐Odasso, Manuel AU - Montero-Odasso, Manuel AU - Kamkar, Nellie AU - Pieruccini‐Faria, Frederico AU - Osman, Abdelhady AU - Sarquis‐Adamson, Yanina AU - Close, Jacqueline AU - Hogan, David B. AU - Hunter, Susan Winifred AU - Kenny, Rose Anne AU - Lipsitz, Lewis Arnold AU - Lord, Stephen R. AU - Madden, Kenneth Michael AU - Petrović, Mirko AU - Ryg, Jesper AU - Speechley, Mark AU - Tan, Maw Pin AU - Tan, Maw Pin AU - Velde, Nathalie van der AU - Verghese, Joe AU - Masud, Tahir AU - Adults, Task Force on Global Guidelines for Falls in Older AU - Petrović, Mirko AU - Nieuwboer, Alice AU - Vlaeyen, Ellen AU - Milisen, Koen AU - Ryg, Jesper AU - Kenny, Rose Anne AU - Bourke, Robert AU - Hartikainen, Sirpa A. AU - Cammen, Tischa J. M. van der AU - Velde, Nathalie van der AU - Masud, Tahir AU - Todd, Chris J. AU - Martin, Finbarr C. AU - Marsh, David AU - Lamb, Sallie AU - Frith, James AU - Logan, Pip AU - Skelton, Dawn Ann AU - Blain, Hubert AU - Anweiller, Cedric AU - Freiberger, Ellen AU - Becker, Clemens AU - Cesari, Matteo AU - Casas-Herrero, Alvaro AU - Jara, Javier Perez AU - Bouzòn, Christina Alonzo AU - Welmer, Anna‐Karin AU - Birnghebuam, Stephanie AU - Kressig, Reto Werner AU - Montero-Odasso, Manuel AU - Montero-Odasso, Manuel AU - Speechley, Mark AU - McIlroy, Bill AU - Hunter, Susan AU - Camicioli, Richard M. AU - Madden, Kenneth AU - Norris, Mireille AU - Watt, Jennifer AU - Mallet, Louise AU - Hogan, David B. AU - Verghese, Joe AU - Sejdić, Ervin AU - Ferrucci, Luigi AU - Lipsitz, Lewis Arnold AU - Ganz, David A. AU - Alexander, Neil B. AU - Giber, Fabiana AU - Schapira, Marcelo Carlos AU - Jauregui, Ricardo AU - Cuellar, Felipe Melgar AU - Abreu, Daniela Cristina Carvalho de AU - Lourenço, Roberto Alves AU - Pierrucini, Monica AU - Ceriani, Alejandro AU - Marín-Larraín, Pedro AU - Espinola, Homero Gac AU - Gómez-Montes, José Fernando AU - Cano-Gutierrez, Carlos Alberto AU - Ulate, Xinia Ramirez AU - Ovares, José Ernesto Picado AU - Buendia, Patricio Gabriel AU - Tito, Susana Lucia AU - Padilla, Diego Martínez AU - Aguilar-Navarro, Sara G. AU - Avila-Funes, Alberto AU - Moctezum, Rogelio AU - Ávila‐Funes, José Alberto AU - Gutiérrez‐Robledo, Luis Miguel AU - Alemán, Luis Manuel Cornejo AU - Caona, Edgar Aguilera AU - Carbajal, Juan Carlos AU - Parodi, Jose Francisco AU - Sgaravatti, Aldo AU - LORD, STEPHEN AU - Sherrington, Catherine AU - Said, Cathy AU - Cameron, Ian Douglas AU - Morris, Meg AU - Duque, Gustavo AU - Close, Jacqueline AU - Kerse, Ngaire M AU - Tan, Maw Pin AU - Duan, Leilei AU - Sakurai, Ryota AU - Won, Chang Won AU - Negahban, Hossein AU - Won, Chang Won AU - Hausdorff, Jeffrey M. AU - Kalula, Sebastiana AU - Kobusingye, Olive Chifefe TI - Evaluation of Clinical Practice Guidelines on Fall Prevention and Management for Older Adults JO - JAMA Network Open VL - 4 IS - 12 SP - e2138911 PY - 2021 DA - 2021/12/15 DO - 10.1001/jamanetworkopen.2021.38911 UR - https://doi.org/10.1001/jamanetworkopen.2021.38911 ER -
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