$4m study to transform falls prevention

Dr Alison Pighills, a JCU Adjunct Associate Professor and Principal Research Fellow with Mackay Hospital and Health Service, will lead the study.

“It involves looking at the environmental hazards within somebody’s home and the person’s internal risk factors, such as if they use a mobility aid, their functional independence, age, gender and ethnicity,” Dr Pighills said.

The study will trial the adoption of an Environmental Assessment and Modification (EAM) framework for Occupational Therapists (OTs) to use with clients at high risk of falls over the age of 65.

“The focus of this study is about changing practice and implementation. EAM is something OTs do a lot but not necessarily to look at people’s risk of falling,” Dr Pighills said.

“Another area this framework looks at is the tasks a person engages in within the home, so the risk level in terms of their behaviour such as alcohol intake, the choice of clothing, which might present a tripping hazard, and choice of footwear.”

Set to begin later this year, the five year study will be progressively rolled out with OTs in 12 sites - ten across Queensland and two sites in other states, including OTs from within the public and private health system, non-government organisations and community-based services.

“We hope to develop resources that are bespoke to whatever each service needs,” Dr Pighills said.

“We’re also going to monitor the number of falls clients have over that period.”

Dr Pighills said a recent Cochrane systematic review she co-authored had already proven the framework was highly effective in reducing the rate of falls by about 39 per cent in elderly people with three or more falls risk factors.

“One of the reasons why we think EAM is so effective is because it’s a partnership approach with the client,” she said.

“The person will identify what they think increases their risk of falling when they feel unsafe doing certain tasks, and the OT will encourage them to not only identify their own risks but also identify their own solutions.

“We hope this study will have a massive impact on reducing the risk of falls for elderly people not just within Australia but worldwide.”

Elderly clients in remote locations could also benefit from EAM if it could be adapted to work with telehealth, Dr Pighills said.

“There’s nothing to say an Occupational Therapist couldn’t carry out that assessment if a relative or healthcare support worker recorded the client at home doing functional tasks,” she said.

“That’s where I want to go with it so we make this intervention accessible to more people who live in those remote areas.”

Dr Pighills and her team will supervise home visits of participating OTs during the study to ensure they properly implemented the EAM framework and audit their case notes.

“We want to develop the educational resources, support networks and training for Occupational Therapists to change their practice and implement what we know is clinically effective,” she said.

JCU Head of OT Dr Daniel Lowrie and OT Lecturer Susan Melchert are also part of Dr Pighills’ study.

The study received more than $2.6m from the Federal Government’s Medical Research Future Fund and an additional $1.4 million in in-kind support from 10 collaborating organisations, including seven universities.

A yearly $28,000 stipend is available for JCU PhD students interested in joining the study, with interested students urged to contact alison.pighills@jcu.edu.au