New falls prevention guidelines released

An RACGP expert has welcomed an update to national fall prevention guidelines for older Australians, which includes a risk assessment tool for GPs and a focus on multidisciplinary care between GPs, allied healthcare providers and family.
 
Dr Anthony Marinucci, Chair of RACGP Specific Interests Aged Care, said the updated guidelines from the Australian Commission on Safety and Quality in Health Care represent ‘a shift towards a more nationally consistent and evidenced-grounded guideline in community settings’.
 
‘It’s excellent that [the guidelines] have been reviewed and re-released,’ he told newsGP.
 
In their first update since 2009, the new guidelines are the latest response to recommendations from the Royal Commission into Aged Care Quality and Safety, and have been developed to align with the Strengthened Aged Care Quality Standards, which will take effect from 1 November 2025.
 
Falls were the leading cause of injury hospitalisations in Australia in 2023–24, according to the Australian Institute of Health and Welfare. Further, over the same period, those aged 65 years and over were almost 12 times as likely to be hospitalised from a fall than those aged 25–44 years.
 
Dr Marinucci said he is pleased the new guidelines provide a more structured ‘risk-rated program’ and an emphasis on a multidisciplinary approach.
 
‘It’s not just siloed care from every single healthcare professional. I think it’s a really important step in the right direction,’ he said.
 
‘On a secondary issue, the changes to the care planning that have happened recently in general practice, where there’s a little bit less requirements for the team care planning documentation, I think that will lead in well to this whole multidisciplinary approach.’
 
The guidelines define ‘older people’ as aged 65 years and older, or 50 and above for Aboriginal and Torres Strait Islander peoples, but also apply to people outside those age groups at increased risk of falls due to disability or conditions affecting functional ability, or with a history of falls.
 
The guidelines are tailored across three healthcare settings: hospitals, residential aged care services (RACS) and community care.
 
The RACS guidelines have seven recommendations, including multifactorial interventions, hip protectors, tailored and continued exercise, dairy food requirements, osteoporosis medicines and vitamin D supplements.
 
The community care guidelines have 14 recommendations, including education and exercise, home safety interventions, and interventions for specific risk factors including eyewear prescriptions, podiatry and pacemakers.
 
Dr Marinucci said the main difference between the two guidelines is that aged care residents ‘are all assumed to be high risk of falling, as opposed to community-based residents’.
 
‘There is a risk stratified approach, and therefore there’s a slightly different lens on the two different guidelines, which I think is very, very important,’ he said.
 
‘Stratifying that everyone is high risk in residential aged care is a new thing.’
 
Under the community care guidelines, doctors can identify patients’ care goals, while focusing on maintaining independence and quality of life.
 
The guidelines also recommend carer and family involvement to the extent the older person chooses, as well as shared decision making on fall prevention interventions.
 
‘Engaging multidisciplinary teams, the older person and their carers and family is crucial to fall prevention,’ states the guideline.
 
Dr Marinucci recommends GPs read the fact sheets for RACS and community care that summarise the new guidelines.
 
‘They’re excellent because they really distil down the message exactly in a couple of pages,’ he said.
 
‘These interventions and these new guidelines, they’re actually really beneficial. If they’re followed, we should really see a reduction in falls, and if there’s a reduction in falls, we will then see a reduction in harm and hospitalisations. There’s absolutely no doubt about that.’
 
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