Article type
Abstract
"Background: Falls are a common problem that can occur at any age. The burden of falls across the lifespan is substantial, and many falls are preventable. Given the variety of clinical practice guidelines available for the prevention, assessment and management of falls, it is useful to understand the quality of these guidelines and the clinical applicability of their recommendations.
Objective: To critically assess the quality and applicability of clinical practice guidelines for falls prevention, assessment and management across the lifespan.
Methods: The present systematic review was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Cumulative Index to Nursing & Allied Health (CINAHL), Cochrane, Embase, Medline and 26 grey literature databases were searched from January 2016 to July 2023, using terms related to clinical practice guidelines and falls. Eligibility criteria were established a priori and two investigators assessed the methodological quality of the guidelines and recommendations. Scaled domain scores were calculated for Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and the Appraisal of Guidelines Research and Evaluation – Recommendation Excellence (AGREE-REX) tool. Domain scores were averaged to provide an overall mean score for each guideline. Guidelines with an overall score ≤30% were defined as low quality, 31-69% moderate quality and ≥70% high quality.
Results: Database searches yielded 5557 articles. Of these, nine guidelines met the eligibility criteria and were included. Seven guidelines provided recommendations for older adults, while one focused on children and one on adults. Overall AGREE II scores ranged from 29% to 83%, while AGREE-REX scores were slightly lower ranging from 39% to 56%. Two guidelines were deemed high quality.
Conclusion: This review identified significant gaps in evidence-based guidelines for falls prevention, particularly for individuals under age 65. Variations in guideline quality suggest the need for enhanced stakeholder involvement and applicability of guidelines. The findings provide a foundation for future guideline development and underscore the urgency of developing inclusive, evidence-based guidelines to address falls across the lifespan. Improved guidelines have the potential to reduce the economic burden of fall-related injuries and enhance overall well-being across diverse age groups."
Objective: To critically assess the quality and applicability of clinical practice guidelines for falls prevention, assessment and management across the lifespan.
Methods: The present systematic review was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Cumulative Index to Nursing & Allied Health (CINAHL), Cochrane, Embase, Medline and 26 grey literature databases were searched from January 2016 to July 2023, using terms related to clinical practice guidelines and falls. Eligibility criteria were established a priori and two investigators assessed the methodological quality of the guidelines and recommendations. Scaled domain scores were calculated for Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and the Appraisal of Guidelines Research and Evaluation – Recommendation Excellence (AGREE-REX) tool. Domain scores were averaged to provide an overall mean score for each guideline. Guidelines with an overall score ≤30% were defined as low quality, 31-69% moderate quality and ≥70% high quality.
Results: Database searches yielded 5557 articles. Of these, nine guidelines met the eligibility criteria and were included. Seven guidelines provided recommendations for older adults, while one focused on children and one on adults. Overall AGREE II scores ranged from 29% to 83%, while AGREE-REX scores were slightly lower ranging from 39% to 56%. Two guidelines were deemed high quality.
Conclusion: This review identified significant gaps in evidence-based guidelines for falls prevention, particularly for individuals under age 65. Variations in guideline quality suggest the need for enhanced stakeholder involvement and applicability of guidelines. The findings provide a foundation for future guideline development and underscore the urgency of developing inclusive, evidence-based guidelines to address falls across the lifespan. Improved guidelines have the potential to reduce the economic burden of fall-related injuries and enhance overall well-being across diverse age groups."