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 the intervention may be more effective/beneficial than the comparison for key outcomes. However, this is uncertain and new evidence could change this in the future.
Population: Older people living in the community
Intervention: Multifactorial interventions ᵃ ᵇ
Comparison: Usual care or attention control ᵃ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Number of falls per person year | Favours intervention | Low |
At least one fall (follow‐up: 3-48 months) | No statistically significant difference | Low |
Recurrent falls (follow‐up: 6-24 months) | No statistically significant difference ᶜ | Low |
At least one fall‐related fracture (follow‐up: 3-48 months) | No statistically significant difference | Low |
Falls requiring hospital admission (follow‐up: 3-36 months) | No statistically significant difference | Low |
Falls requiring medical attention (follow‐up: 12-24 months) | No statistically significant difference | Low |
Health‐related quality of life (follow-up: 3-12 months) | Favours intervention ᵈ | Low |
Adverse events | See note ᵉ | GRADE assessment not performed for this outcome |
Note ᵃ This evidence table summarises the findings for the comparison of multifactorial interventions versus usual care or attention control, which is the main comparison as stated in the Cochrane review Summary of Findings table. See the full CCA for information on the other included comparison group (multifactorial interventions versus exercise alone). ᵇ Multifactorial interventions include exercise, environment/assistive technologies (e.g., home‐hazard assessment and modifications, referral to occupational therapy, medication review), and psychological interventions (e.g., cognitive behavioural intervention or referral to mental health services). ᶜ Fewer people in the intervention group had recurrent falls over 6 to 24 months, but this difference was not statistically significant. ᵈ Although the difference in scores was statistically significant it did not reach clinical significance. ᵉ Results reported narratively (three RCTs with 659 participants reported on adverse effects with multifactorial interventions; one study reported that two people had back pain, one reported ten people with musculoskeletal symptoms, and the third reported no adverse effects).
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.
- Can multifactorial interventions help prevent falls among older people living in the community?
- Can multicomponent interventions help prevent falls among older people living in the community?
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