|Jerry Gurwitz, MD, serves on the steering committee for the study and leads the MPCI research team.
Falls are the leading cause of injury-related morbidity and mortality among older adults, with more than one in three older adults falling each year, resulting in direct medical costs of nearly $30 billion, according a recent report by the Centers for Disease Control. In an effort to drastically reduce the number of falls in older adults, the National Institutes of Health and the Patient Centered Outcomes Research Institute have partnered to launch a $30 million, five-year intervention study. The Meyers Primary Care Institute (MPCI) at UMass Medical School is one of 10 sites taking part in the study.
“Patient involvement in this grant is unique—we need to show that the affected population is directly engaged in the design and implementation of the interventions based on individual needs and local community resources,” said Jerry Gurwitz, MD, the Dr. John Meyers Professor of Primary Care Medicine, MPCI executive director and chief of the Division of Geriatric Medicine at UMMS. Dr. Gurwitz serves on the steering committee for the study and leads the MPCI research team participating in the comprehensive study that will enroll 6,000 older adults at high risk for falling across 10 clinical sites nationwide.
While prior studies have analyzed risk factors for falls and interventions, best evidence about how to prevent falls has not been widely adopted. This study will take a different approach: it will integrate proven fall reduction strategies into a practical intervention that can be adopted by many health care systems.
“This collaboration with PCORI exemplifies our efforts to go beyond the norms to solve the nation’s health issues,” said NIH Director Francis S. Collins, MD, PhD. “The problems we face are complex and therefore require thoughtful and complex solutions. I am hopeful this initiative will greatly improve the lives of those most at risk for falls.”
As director of the Meyers Primary Care Institute, a partnership of UMass Medical School, Reliant Medical Group and Fallon Health, Dr. Gurwitz will serve as the site principal investigator for the grant, which is called STRIDE (Strategies To Reduce Injuries and Develop confidence in Elders). At least 600 patients will be recruited from patients receiving care at primary care practices within Reliant Medical Group.
“The study is a multi-site cluster randomized clinical trial, with patients at half of the practices receiving the falls intervention and patients receiving care at other practices serving as the control group. Those individuals will receive usual care but no special intervention,” said Gurwitz.
Each person in the trial will be assessed for his or her risk of falling, and receive either the current standard of care (primarily information about preventing falls) or the experimental study intervention in which individualized care plans will be developed and administered. The intervention centers on the concept of a nurse falls care manager working with each participant’s primary care provider to develop customized plans and monitor success. The plans will include proven fall risk reduction interventions that can be implemented by primary care physicians and other health care providers, caregivers and community-based organizations.
The ambitious goals of this grant reflect PCORI’s mission to help people make informed health care decisions and improve health care delivery and outcomes. Patients and other stakeholders will partner with the investigators in national and local councils throughout the study development process and will continue to be engaged during the trial at national and local levels.