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 ORCID: https://orcid.org/0000-0001-9503-9562, 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:	Schools > Psychology
Publisher:	NETSCC
ISSN:	1366-5278
Funders:	Health Technology Assessment
Last Modified:	23 Oct 2022 12:54
URI:	https://orca.cardiff.ac.uk/id/eprint/109012

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