Primary Care Physicians Perceptions and Practices Regarding Fall Prevention in Adult's ≥ 65 years

Background: Falls are the leading cause of injury deaths and the most common cause of disability, premature nursing home admissions, medical costs, and hospitalizations among people ≥65 years. Interventions targeting multiple fall risk factors can reduce fall rates by 30-40%. Yet, national studies show that screening conducted by physicians for older adult falls is short of acceptable standards. This project was conducted by Tri-County Health Department (TCHD) in Colorado and examined fall prevention practices for primary care physicians in our jurisdiction. Methods: TCHD randomly sampled primary care physicians (n= 99) obtained from a statewide healthcare provider database about fall prevention screening during routine healthcare visits and perceived barriers. Data were analyzed using chi-square and Student's t-tests initially, then multiple logistic regression. Results: Response rate was 67%. Only 25% of respondent physicians base their fall prevention practices on clinical guidelines from any recognized organizations. Frequent barriers reported included lack of time during visits, more pressing issues, and lack of educational materials. Solo practice physicians (OR 6.95 [95% CI 1.100-43.93]) and physicians who accept Medicare (OR 10.64 [95% CI 100-1.09]) were significantly more likely to counsel patients on fall risk factors than those in group practice or those that don't accept Medicare, respectively. Conclusions: This study reveals certain physician sub-groups that require targeted interventions to improve fall prevention practices as well as education on clinical guidelines. Recommendations include providing physicians with screening guides, educational materials, environmental/home safety checklists, and referral resources tailored to each physician sub-group.