Objectives To assess the effectiveness of a trained district nurse individu
ally prescribing a home based exercise programme to reduce falls and injuri
es in elderly people and to estimate the cost effectiveness of the programm
Design Randomised controlled trial with one year's follow up.
Setting Community health service at a New Zealand hospital.
Participants 240 women and men aged 75 years and older.
Intervention 121 participants received the exercise programme (exercise gro
up) and 119 received usual care (control group); 90% (211 of 233) completed
Main outcome measures Number of falls, number of injuries resulting from fa
lls, costs of implementing the programme, and hospital costs as a result of
Results Falls were reduced by 46% (incidence rate ratio 0.54, 95% confidenc
e interval 0.32 to 0.90). Five hospital admissions were due to injuries cau
sed by falls in the control group and none in the exercise group. The progr
amme cost $NZ1803 (pound 523) (at 1998 prices) per fall prevented for deliv
ering the programme and $NZ155 per fall prevented when hospital costs avert
ed were considered.
Conclusion A home exercise programme, previously shown to be successful whe
n delivered by a physiotherapist, was also effective in reducing falls when
delivered by a trained nurse from within a home health service. Serious in
juries and hospital admissions due to falls were also reduced. The programm
e was cost effective in participants aged 80 years and older compared with