Implementing a Falls Conversation Package in General Practice: A Service Evaluation.

Background/

Objectives

Falls-prevention advice in primary care does not always lead to a practical next step. We evaluated a brief, non-clinical Falls Conversation package at one urban NHS general practice.

Methods

During a 12-week quality improvement/service evaluation, patients aged 65 years or older were offered a baseline reflection survey, written information, a home-safety checklist and, in later Plan-Do-Study-Act (PDSA) cycles, a one-action prompt. The package did not include clinical assessment, treatment, referral or medication review. Matched pre-post outcomes were analysed, with actions and balancing outcomes recorded at four to six weeks.

Results

Of 510 eligible patients, 442 were approached, 334 engaged, 295 provided matched pre-post data and 256 completed follow-up. The mean project-specific knowledge score was 1.83 (SD 1.02) before and 2.60 (SD 0.95) immediately after the package, a paired difference of 0.77 out of 4 (95% CI 0.65 to 0.88; Cohen's d_z = 0.79; p < 0.001). Worry changed by -0.07 out of 5 (95% CI -0.13 to -0.01; d_z = -0.13), and activity avoidance by -3.4 percentage points (95% CI -7.5 to 0.7; p = 0.144). At follow-up, 157/256 participants reported at least one action (61.3%, 95% CI 55.2% to 67.1%); actions were heterogeneous and unverified. Action selection and completion rose descriptively across non-randomised PDSA cohorts.

Conclusions

The package appeared feasible to embed in one practice and was associated with higher immediate knowledge scores and patient-reported action. It did not demonstrate reduced falls or clinically meaningful change in fear-related outcomes. Controlled studies using validated measures, objective outcomes and longer follow-up are required.