Implementing a Multidisciplinary Fall Prevention Model in Primary Care: Outcomes from a Geriatric Fall Clinic
Chitima Boongird, Thanit Veerapong, Wannisa Wongpipathpong, Konlawat Sabsuantang, Pritsana Punyawai, Sarayut Nijvipakul, Kamonporn Suwanthaweemeesuk, Peerapong Wongsawan, Sarawadee YodbuteAbstract
Background
Falls are a leading cause of injury and mortality among older adults; however, structured fall prevention programs are underutilized in primary care. This study evaluated the implementation and effectiveness of a multidisciplinary geriatric fall clinic embedded within a primary care setting, focusing on fall reduction, injury prevention, functional improvement, and patient-centered outcomes.
Methods
This prospective observational study included adults at least 60 years of age who completed baseline and 6-month follow-up assessments at a primary care–based geriatric fall clinic. A multidisciplinary team conducted comprehensive fall risk assessments and implemented individualized interventions, including medication review and deprescribing, osteoporosis management, nutritional optimization, and dementia care coordination. Patients with visual, musculoskeletal, or neurological issues were fast-tracked to appropriate specialists. Primary and secondary outcomes, including fall incidence, injury rates, functional mobility, and patient/caregiver satisfaction, were assessed at baseline and follow-up.
Results
After six months, the mean number of falls per patient declined significantly (2.10 ± 3.49 to 0.55 ± 2.22, p < 0.001), and the proportion of fallers dropped from 82.8% to 21.5% (p < 0.001). Fall-related injuries decreased from 51.6% to 5.4% (p < 0.001). Functional mobility improved across the following indicators: Timed Up and Go (22.6% to 41.9%, p = 0.0035), 30-second chair stand (12.5% to 33.3%, p = 0.0039), tandem stance (15.4% to 32.1%, p = 0.0016), and handgrip strength (27.3% to 39.4%, p = 0.021). Over 80% of patients and caregivers reported high satisfaction with the clinic. Risk factors for recurrent falls included sedative/antipsychotic use and residence in multistory commercial buildings.
Conclusion
Embedding a multidisciplinary fall prevention clinic within primary care is a feasible and effective strategy for improving safety, mobility and satisfaction among older adults. Key strategies for managing fall risk in this population include deprescribing sedative and antipsychotic medications and providing targeted education on home safety. These findings support the broader integration of fall prevention services into routine care to promote early identification and targeted interventions for fall risk.