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New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
1. A New Patient-Centered Study on
Preventing Fall-Related Injuries in
Older Adults
A PCORI-NIH Webinar/Teleconference
June 4, 2013
1:00 p.m. – 2:00 p.m.
2. 2New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
Bryan Luce, PhD, MBA
Chief Science Office,
PCORI
Welcome
3. Welcome
• Webinar participants can ask questions via the
webinar “chat” feature or via Twitter, #PCORI.
• Submitted questions will be discussed during the
public comment periods after panelists’ remarks.
Members of the media on deadline, please identify
yourself so we may triage your questions.
3New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
4. Preventing Fall-Related
Injuries in Older Adults
Bryan Luce, PhD, MBA, Chief Science Officer
June 4, 2014
4New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
5. About PCORI
PCORI helps people make informed health care
decisions, and improves health care delivery and
outcomes, by producing and promoting high integrity,
evidence-based information that comes from
research guided by patients, caregivers and the
broader health care community.
Pictured: PCORI Board of Governors (March 2012)
5New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
6. What Is Patient-Centered CER?
Comparing two or more options for screening, diagnosis,
treatment
Considering the range of relevant outcomes
Conducting studies in real world populations and real
world settings
Attending to differences in effectiveness and preferences
across patient subgroups
6
PCORI funds comparative effectiveness research (CER) that
answers questions important to patients and other clinical care
decision makers by:
New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
7. Answering Questions That Matter Most to
Patients: Preventing Fall-Related Injuries
PCORI’s patient-centered CER aims to answer
questions that matter most to patients
Falls remain one of the most common causes of
disability and loss of independence among older adults
Unlocking the key to falls prevention will have significant
impact on the health care system and most importantly
patients
Until now, no large-scale study has been undertaken to
identify the most effective combination of falls prevention
strategies to fit the needs of different individuals and
different health care systems
7New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
8. How We Selected Preventing Fall-Related
Injuries as an Important Research Topic
8
PCORI identified fall
prevention as a high-
priority topic through a
stakeholder-driven
process that incorporated
perspectives from all
parts of the health care
community.
New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
9. How We Selected Preventing Fall-Related
Injuries as an Important Research Topic
9
On March 12, 2013, PCORI convened
an ad hoc workgroup consisting of
patients, researchers, stakeholders,
and others to pick out the top-tier
questions related to fall prevention.
Their input ensures that the
research funded will produce
results that are relevant to patients
and those who care for them.
New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
10. About the Funding Announcement
10
• Fall-related injuries in older adults are a critical health
issue.
• Falls represent the leading cause of fatal and nonfatal
injuries among older adults.
• The National Institute on Aging is a perfect fit for this
partnership.
• NIA brings expertise in conditions affecting older
individuals as well as its established infrastructure and
capabilities in managing large, multi-year clinical trials.
• The intent of this collaborative project is to evaluate a
comprehensive, multi-factorial approach to falls.
New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
11. 11New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
Richard J. Hodes, MD
Director, National Institute on
Aging
12. NIH & PCORI:
Fall Prevention Research
With Public, Provider Engagement
Richard J. Hodes, M.D.
Director
National Institute on Aging
NIA-PCORI Award Webinar
June 4, 2014
13. About the National Institute on Aging
• NIA is one of 27 Institutes and Centers of the
National Institutes of Health
• Established in 1974
14. The National Institute on Aging at NIH
• Conducts research
• Trains and develops research scientists
• Provides research resources
• Disseminates information
on health and research
advances
15. Why focus on falls in older people?
Falls are a common but serious problem:
• Approximately one in three older Americans falls
each year and 20-30% of those who fall suffer
moderate to severe injuries such as lacerations,
hip fractures, or head trauma.
• These injuries may lead to a loss of independence
or death.
• Risk factors include illness, functional
impairments, and environmental hazards.
16. What We Know, What We Need to Know
• Some tested interventions have substantial effects;
others little or none.
• Multifactorial interventions have been successful but
unable to be broadly applied.
• Strategies now need to be tested in different practice
settings with different populations to see how
individual, practice, health care systems-related
barriers can be overcome to reduce falls and fall-
related serious injuries.
17. Making a Difference in the Community: the
Value of Collaborating with PCORI
• Meaningful involvement of patients and stakeholders, as
partners with researchers
• PCORI engagement may help overcome barriers to research and
implementation success:
Help facilitate provider adherence to future guidelines
Help providers facilitate improvements in patients’ home
safety
Improve patients’ adoption of recommended risk-modifying
behaviors
Connect and coordinate provider efforts to reduce risk (e.g.,
coordinating medication adjustment across several
providers)
18. RFA-AG-14-009 – NIH Invites Applications
for Major Study
• Fall Injuries Prevention Partnership, a research
partnership between IC/NIH and PCORI, with funds
provided by PCORI to NIH
• RFA developed by NIA staff, PCORI identified as partner
• NIA and PCORI share understanding of RFA, study aim to
address personal, public health burden of serious falls
• RFA published July 2013
• RFA invited applications for randomized clinical trial of
multifactorial strategy for preventing serious fall-related
injuries among non-institutionalized older people
• Applications reviewed February 2014
19. The Study
• Randomized Trial of a Multifactorial Fall Injury Prevention
Strategy
• $30 million, 5-year study supported with funds from PCORI
and led by NIA and team of investigators
• Joint Principal Investigators:
o Dr. Shalender Bhasin, Brigham and Women’s Hospital, Harvard Medical
School
o Dr. Thomas Gill, Yale School of Medicine
o Dr. David Reuben, David Geffen School of Medicine, UCLA
• Study will test an individually tailored prevention strategy and
concept of a fall care manager in various health care systems,
communities
• Primary outcome: reduction in serious fall injuries
20. Communicating Principal Investigator
20New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
Shalender Bhasin, MD
Harvard Medical School/
Brigham and Women’s
Hospitals
21. Patient Perspective
Martie Carnie
Co-chair, Brigham & Women’s
Hospital’s Patient and Family
Advisory Council
21New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults
25. Audience Question and Answer
To participate:
• Webinar participants can ask questions via the
webinar “chat” feature or via Twitter using #PCORI.
• Members of the media on deadline, please identify
yourself so we may triage your questions.
25New Patient-Centered Study on Preventing Fall-Related Injuries in Older Adults