A feasibility study of a cluster randomised controlled trial to evaluate a falls prevention intervention in care homes for older people
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Background: Falls are common and distressing for care home residents and can incur large costs. Implementation of the Guide to Action Care Home (GtACH) tool is a promising approach to prevent falls. Objective: To examine the feasibility of conducting a large scale cluster RCT of the implementation of the GtACH tool. Method: Care homes were randomised to either receive the GtACH intervention or usual care. Baseline and 6 month outcomes assessed trial design. Trial design parameter data included measuring recruitment, attrition and data collection. Feasibility of accelerometer wear as an activity measure was tested in participants. Concurrent process evaluation techniques; including care staff interview and research field notes provided data regarding trial design and intervention feasibility. Results: 22/145 (15%) care homes agreed to take part. Our recruitment target of 6 care homes was met. 52 out of the proposed target of 68 residents (76%) were recruited. 3 homes were randomised to the intervention, 3 to control. 36/115 (31%) home staff were trained to use the GtACH. Two home received protocol compliant training. 10 (19%) participants were lost at follow up, 7 died, 3 moved home. All homes provided falls data with no duplications and little missing descriptive information. Accelerometers were not deemed feasible in 10 residents. The process evaluation revealed high acceptability, safety and intervention adherence with evidence based revisions necessary to optimise trial design and intervention implementation. Conclusion: The GtACH intervention and RCT design is feasible and implementable in care homes. A definitive effectiveness trial is warranted.