The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention

Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management

David B. Reuben, Priscilla Gazarian, Neil Alexander, Katy Araujo, Dorothy Baker, Jonathan F. Bean, Chad Boult, Peter Charpentier, Pamela Duncan, Nancy Latham, Rosanne M. Leipzig, Lisa M. Quintiliani, Thomas Storer, Siobhan Mcmahon

Research output: Contribution to journalArticle

Abstract

In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs). The components include a standardized assessment of eight modifiable risk factors (medications; postural hypotension; feet and footwear; vision; vitamin D; osteoporosis; home safety; strength, gait, and balance impairment) and the use of protocols and algorithms to generate recommended management of risk factors; explanation of assessment results to the patient (and caregiver when appropriate) using basic motivational interviewing techniques to elicit patient priorities, preferences, and readiness to participate in treatments; co-creation of individualized falls care plans that patients' PCPs review, modify, and approve; implementation of the falls care plan; and ongoing monitoring of response, regularly scheduled re-assessments of fall risk, and revisions of the falls care plan. Custom-designed falls care management software facilitates risk factor assessment, the identification of recommended interventions, clinic note generation, and longitudinal care management. The trial testing the effectiveness of the STRIDE intervention is in progress, with results expected in late 2019.

Original languageEnglish (US)
JournalJournal of the American Geriatrics Society
DOIs
StateAccepted/In press - 2017

Fingerprint

Patient Participation
Risk Management
Nurses
Wounds and Injuries
Primary Health Care
National Institute on Aging (U.S.)
Patient Outcome Assessment
Pragmatic Clinical Trials
Motivational Interviewing
Orthostatic Hypotension
Patient Preference
Gait
Vitamin D
Caregivers
Osteoporosis
Foot
Patient Care
Software
Safety
Therapeutics

Keywords

  • Cluster-randomized clinical trial
  • Falls
  • Injuries
  • Prevention

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention : Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management. / Reuben, David B.; Gazarian, Priscilla; Alexander, Neil; Araujo, Katy; Baker, Dorothy; Bean, Jonathan F.; Boult, Chad; Charpentier, Peter; Duncan, Pamela; Latham, Nancy; Leipzig, Rosanne M.; Quintiliani, Lisa M.; Storer, Thomas; Mcmahon, Siobhan.

In: Journal of the American Geriatrics Society, 2017.

Research output: Contribution to journalArticle

Reuben, DB, Gazarian, P, Alexander, N, Araujo, K, Baker, D, Bean, JF, Boult, C, Charpentier, P, Duncan, P, Latham, N, Leipzig, RM, Quintiliani, LM, Storer, T & Mcmahon, S 2017, 'The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management', Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.15121
Reuben, David B. ; Gazarian, Priscilla ; Alexander, Neil ; Araujo, Katy ; Baker, Dorothy ; Bean, Jonathan F. ; Boult, Chad ; Charpentier, Peter ; Duncan, Pamela ; Latham, Nancy ; Leipzig, Rosanne M. ; Quintiliani, Lisa M. ; Storer, Thomas ; Mcmahon, Siobhan. / The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention : Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management. In: Journal of the American Geriatrics Society. 2017.
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