Developing a Fall Risk Identification and Management Model to Prevent Falls in Older Veterans Using Primary Care and Telehealth

What this Trial Is About

Falls are a frequent concern for older adults, especially Veterans, who face a higher risk of falling than non-Veterans. These falls can lead to serious injuries like traumatic brain injuries and hip fractures, resulting in emergency visits, hospital stays, and even death. The Veterans Health Administration VHA currently focuses fall prevention on inpatient and nursing home care, but there is a significant need to support older Veterans living independently in the community. This research aims to develop and test a Fall Risk Identification and Management FRIM model to proactively reduce falls among older Veterans receiving primary care. The FRIM model involves a three-stage process brief fall risk screening during routine primary care visits, telehealth assessments to identify specific fall risk factors, and referrals to existing VHA care pathways tailored to address those risks. These pathways include physical strengthening programs like physical therapy or Gerofit, psychological support through cognitive behavioral therapy, medication review and deprescription by clinical pharmacy, and home safety modifications by occupational therapy. Participants will be randomly assigned to either the FRIM model or the standard care offered in the VHAs GeriPACT clinic. Participants will be involved in screening and assessments of physical, psychological, pharmacological, and environmental fall risks. Researchers will collect data on recruitment, retention, burden of fall risk identification and management, and various functional and safety outcomes over approximately one year and beyond. Measures include physical performance tests, fear of falling surveys, medication reviews, home safety screenings, and tracking of falls and injuries. The study includes double-blind randomization and aims to refine and evaluate the feasibility of the FRIM model to improve fall prevention in older Veterans.

Fall Risk Identification and Management for Older Veterans