預防計畫對於老人跌倒相關傷害之成效：統合分析

Effects of Fall Prevention Programs for Older Adults on Fall-Related Injuries: A Systematic Review and Meta-Analysis

本研究目的為評估預防計畫對老人跌倒相關傷害之成效，從Cochrane Library、Medline、PubMed、PsycARTICLES、PsycINFO、ERIC、AgeLine、CINAHL、Psychology、Behavioral Sciences Collection databases等，蒐集所有相關的臨床隨機試驗研究，文獻年代範圍從1996年至2016 年間，並應用探索性統合分析，計算老人跌倒預防計畫之效果量。共計33 篇期刊論文納入分析（68,736 人），探索性統合分析結果顯示，跌倒預防計畫對因跌倒所造成的傷害具顯著效果（OR＝0.86, 95% CI：0.75-0.97），但是對於骨折的預防效果則介於邊緣性顯著差異（OR＝0.80, 95% CI：0.63-1.03）。此外，跌倒預防計畫若是不分男女、介入內容包含健康照護專家、當參與者超過20%具跌倒經驗、社區為介入場域、包含多元介入等，本研究發現預防計畫對於預防跌倒相關傷害具有小卻顯著的效果，因此，未來規劃跌倒預防計畫時，政策制定者及臨床工作者應考量不同特性的老人，並提出合適的介入計畫。

This study aimed to evaluate the effects of fall prevention programs on fall-related injuries, and the characteristics of these programs. The Cochrane Library, Medline, PubMed, PsycARTICLES, PsycINFO, ERIC, AgeLine, CINAHL, Psychology and Behavioral Sciences Collection databases were searched for randomized clinical trials on fall-related injuries among older adults from 1996 to 2016. A meta-analysis was performed to calculate the combined effects of fall prevention programs on fall-related injuries. A total of 33 research papers were included in the meta-analysis (68,736 participants). The meta-analysis found that fall prevention programs had a significant effect in preventing fall-related injuries (OR=0.86, 95% CI: 0.75-0.97), but a borderline-significant effect in preventing fractures (OR=0.80, 95% CI: 0.63-1.03). The fall prevention programs had a significant effect on fall-related injuries when both male and female participants were included in the study sample, interventions involved healthcare professionals, more than 20% of the patient population had a history of falling, interventions occurred in the community setting, and multiple interventions were used. Thus, fall prevention programs had a small but significant effect in preventing fall-related injuries but only a borderline effect in preventing fractures. When planning fall prevention programs, future policy makers and clinical workers should consider the different characteristics of older adults to propose appropriate intervention programs.