Final Research Plan
Falls Prevention in Community-Dwelling Older Adults: Interventions
July 21, 2022
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
- Do interventions to prevent falls in unselected or increased-risk community-dwelling older adults reduce falls, fall-related morbidity, or mortality?
- How is “increased risk” defined in the included trials?
- Do interventions to prevent falls in unselected or increased-risk community-dwelling older adults result in any adverse effects?
Contextual questions will not be systematically reviewed and are not shown in the Analytic Framework.
- What is the prognostic accuracy of falls risk assessment tools that are feasible for administration in primary care?
The Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Review. Criteria are overarching as well as specific to each of the key questions (KQs).
|Aim||Trials with the primary or secondary aim of reducing falls or fall-related injuries||Comparative effectiveness trials of fall interventions|
Community-dwelling, ambulatory adults age 65 years or older who are unselected for risk or at increased risk for falls
Interventions that are primary care feasible or referable
Categories of included interventions:
Interventions may be delivered alone or in combination
Categories of excluded interventions:
|Comparators||Placebo, minimal control (i.e., provision of education via written materials, video, or lecture), or usual care||Active comparators|
KQ 2: Harms outcomes as reported in studies
KQ 2: Minor adverse events that are reported using nonvalidated and nongeneralizable measures
|Followup||Minimum of 6 months followup|
|Study Designs||Randomized, controlled trials||
Editorials, letters, systematic and nonsystematic reviews, opinions, nonrandomized studies of interventions, convenience surveys, and qualitative studies
|Setting||Interventions conducted in primary care or that are referable from primary care|
|Country||Countries categorized as “Very High” on the 2019 Human Development Index (as defined by the United Nations Development Programme)||Countries that are not categorized as “Very High” on the 2019 Human Development Index|
|Language||English only||Non-English-language publications|
|Quality||Fair or good, according to design-specific criteria||Poor, according to design-specific criteria|
The draft Research Plan was posted for public comment on the U.S. Preventive Services Task Force (USPSTF) website from April 21 to May 18, 2022. In response to public comment, the USPSTF will include fall prevention studies recruiting older adults with osteoporosis, osteoarthritis, and sarcopenia. The population designation “average-risk” was also replaced with “unselected” in the analytic framework and key questions and “unselected for risk” in the research approach. The intervention name “medication management” was also changed to “medication modification/review” to better reflect the intended inclusion criteria.