The Prevalence of Falls and Their Correlates Outside the Hospital in Chronic Pain Patients

Purpose:
Outpatient chronic pain patients frequently report falls at clinic visits in our multidisciplinary rural hospital pain center. The purpose of this study is to identify the prevalence of falls and their correlates, which can lead to identification of interventions for falls prevention.

Background/Significance:
Chronic pain patients were reporting falls outside the hospital or clinic environment. They reported causes such as, tripping over objects, legs giving out, and loss of balance. The patients reporting falls are of the average age of 52, outside the elder population that has been studied in relationship to falls, making this a unique population for study. Determining the prevalence of falls and their correlates may lead to effective interventions for falls prevention.

Methods:
At follow up clinic visits patients were asked to voluntarily participate in completing a questionnaire asking if they had experienced falls within the last 30 days, the number of falls experienced, and what they felt caused each fall. The study was conducted from February 21, 2011 until May 31, 2011. There were 761 patient participants. Nursing staff admitting the patient to their visit, introduced the study, requested their participation, obtained consent, provided the questionnaire and assisted in clarifying questions. The investigators assigned each fall to a single correlate. There was 100% inter-rater reliability on correlate assignment.

Results:
761 participants agreed to participate. Seventeen patients declined. Average age of the participants was 52. 187 people reported 310 falls within 30 days prior to their visit. Twenty-six percent of the males reported at least one fall and 24% of the women. One third of the patients reported 1 fall. Twenty-eight percent reported 2 falls, 31% reported 3 falls. Three percent reported 4 falls and 5% reported 5 or more falls. We divided correlates into environmental or patient. Environmental correlates were 46% of the falls and patient correlates were 64%. Three correlates made up 50% of the falls; 1) Legs gave out, 2) Tripped over an object, and 3) loss of balance. Analysis is ongoing.

Conclusions and Implications for Practice:
Correlates of falls suggest areas for interventions; home safety education, balance, strengthening and reconditioning therapy. Fall patient characteristics suggest physical condition is more predictive of falls than age. Prevalence studies such as ours offer opportunities for further study.