REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial

Sahota, Opinder; Drummond, Avril; Kendrick, Denise; Grainge, Matthew J.; Vass, Catherine; Sach, Tracey; Gladman, John R.F.; Avis, Mark

Abstract

Background: falls in hospitals are a major problem and contribute to substantial healthcare burden. Advances in sensor technology afford innovative approaches to reducing falls in acute hospital care. However, whether these are clinically effective and cost effective in the UK setting has not been evaluated. Methods: pragmatic, parallel-arm, individual randomised controlled trial of bed and bedside chair pressure sensors using radio-pagers (intervention group) compared with standard care (control group) in elderly patients admitted to acute, general medical wards, in a large UK teaching hospital. Primary outcome measure number of in-patient bedside falls per 1,000 bed days. Results: 1,839 participants were randomised (918 to the intervention group and 921 to the control group). There were 85 bedside falls (65 fallers) in the intervention group, falls rate 8.71 per 1,000 bed days compared with 83 bedside falls (64 fallers) in the control group, falls rate 9.84 per 1,000 bed days (adjusted incidence rate ratio, 0.90; 95% confidence interval [CI], 0.66-1.22; P = 0.51). There was no significant difference between the two groups with respect to time to first bedside fall (adjusted hazard ratio (HR), 0.95; 95% CI: 0.67-1.34; P = 0.12). The mean cost per patient in the intervention group was £7199 compared with £6400 in the control group, mean difference in QALYs per patient, 0.0001 (95% CI: -0.0006-0.0004, P = 0.67).Conclusions: bed and bedside chair pressure sensors as a single intervention strategy do not reduce in-patient bedside falls, time to first bedside fall and are not cost-effective in elderly patients in acute, general medical wards in the UK. Trial registration: isrctn.org identifier: ISRCTN44972300. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

Citation

Sahota, O., Drummond, A., Kendrick, D., Grainge, M. J., Vass, C., Sach, T., …Avis, M. (2014). REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial. Age and Ageing, 43(2), 247-253. https://doi.org/10.1093/ageing/aft155

• Journal Article Type: Article
• Acceptance Date: Jul 26, 2013
• Online Publication Date: Oct 18, 2013
• Publication Date: 2014-03
• Deposit Date: Apr 28, 2014
• Publicly Available Date: Apr 28, 2014
• Journal: Age and Ageing
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 43
• Issue: 2
• Pages: 247-253
• DOI: https://doi.org/10.1093/ageing/aft155
• Public URL: https://nottingham-repository.worktribe.com/output/996716
• Publisher URL: https://academic.oup.com/ageing/article/43/2/247/10785