Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is very low or low where GRADE has been performed and there may be no difference in effectiveness between the intervention and comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: Older adults admitted to an acute care or subacute care hospital setting ᵃ
Intervention: Multifactorial intervention (including: components of environmental/assistive technology; social environment; knowledge; medication targets; urinary incontinence management; and exercise)
Comparison: Usual care/no additional intervention
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Rate of falls (average follow‐up 4-30 days) ᵇ | No statistically significant difference | Low |
Rate of falls: subgroup analysis acute level of care | No statistically significant difference | Low |
Rate of falls: subgroup analysis subacute level of care | Favours intervention | Low |
Number of people who fell (average follow‐up 4-30 days) | No statistically significant difference | Very Low |
Fracture (average follow‐up 8-30 days) | No statistically significant difference | Very Low |
Adverse events | See note ᶜ | Very Low |
Note ᵃ Acute care hospital setting (1 trial); subacute care (4 trials); both acute and subacute (1 trial). ᵇ The Cochrane Clinical Answer (CCA) states that multifactorial interventions may reduce the rate of falls, but that the difference when compared with usual care/no additional intervention was small. The CCA also notes that further analysis of absolute effect showed considerable variation in the number of falls depending on the baseline risk, ranging from “5 fewer falls per 1000 people at low risk of falling to 61 fewer falls in people at high risk”. See CCA for more details. ᶜ There were no adverse events in either treatment group.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
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