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Support and Assessment for Fall Emergency Referrals (SAFER) 2: a cluster randomised trial and systematic review of clinical effectiveness and cost-effectiveness of new protocols for emergency ambulance paramedics to assess older people following a fall with referral to community-based care when appropriate

Snooks, Helen A, Anthony, Rebecca, Chatters, Robin, Dale, Jeremy, Fothergill, Rachael, Gaze, Sarah, Halter, Mary, Humphreys, Ioan, Koniotou, Marina, Logan, Phillipa, Lyons, Ronan, Mason, Suzanne, Nicholl, Jon, Peconi, Julie, Phillips, Ceri, Phillips, Judith, Porter, Alison, Siriwardena, A Niroshan, Smith, Graham, Toghill, Alun, Wani, Mushtaq, Watkins, Alan, Whitfield, Richard, Wilson, Lynsey and Russell, Ian T 2017. Support and Assessment for Fall Emergency Referrals (SAFER) 2: a cluster randomised trial and systematic review of clinical effectiveness and cost-effectiveness of new protocols for emergency ambulance paramedics to assess older people following a fall with referral to community-based care when appropriate. Health Technology Assessment 21 (13) 10.3310/hta21130

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Abstract

Background: Emergency calls are frequently made to ambulance services for older people who have fallen, but ambulance crews often leave patients at the scene without any ongoing care. We evaluated a new clinical protocol which allowed paramedics to assess older people who had fallen and, if appropriate, refer them to community-based falls services. Objectives: To compare outcomes, processes and costs of care between intervention and control groups; and to understand factors which facilitate or hinder use. Design: Cluster randomised controlled trial. Participants: Participating paramedics at three ambulance services in England and Wales were based at stations randomised to intervention or control arms. Participants were aged 65 years and over, attended by a study paramedic for a fall-related emergency service call, and resident in the trial catchment areas. Interventions: Intervention paramedics received a clinical protocol with referral pathway, training and support to change practice. Control paramedics continued practice as normal. Outcomes: The primary outcome comprised subsequent emergency health-care contacts (emergency admissions, emergency department attendances, emergency service calls) or death at 1 month and 6 months. Secondary outcomes included pathway of care, ambulance service operational indicators, self-reported outcomes and costs of care. Those assessing outcomes remained blinded to group allocation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Publisher: NETSCC
ISSN: 1366-5278
Funders: Health Technology Assessment
Last Modified: 15 Jul 2019 10:20
URI: http://orca-mwe.cf.ac.uk/id/eprint/109012

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