101 an Audit of Falls Risk Assessment in Older Adults in an Irish General Practice

Background Falls in older adults are common; 30% of over 65 s fall at least once a year, increasing to 50% in the over 80s. Falls are associated with significant morbidity and mortality. By 2020 the national economic burden of falls related injury is expected to exceed €2 billion. International guidance recommends annual screening for falls risk in older adults. The Chronic Disease Management programme (CDM) was introduced into Irish General Practice in 2020, but does not include falls risk assessment. The aim of our audit was to evaluate whether GPs are following international guidelines by routinely assessing falls risk in older adults. Methods A full audit cycle was completed in a large Irish general practice with a mixed population. Cycle 1: October 2022. Cycle 2: April 2023. Audit Standard: Opportunistic case finding as per the September 2022 World Guidelines for Falls Prevention and Management in Older Adults: A Global Initiative. Criteria: All patients 65 years of age and older should be asked 3 Key Questions (3KQ): (1) Any falls in the last year? (2) Any unsteadiness when standing or walking? (3) Any fear of falling? All patients meeting referral criteria should be referred. Falls prevention advice should be given routinely. Inclusion criteria: Patients aged 65 years and over attending for routine CDM GP review. Intervention: Practice education session, falls algorithm in every room, consensus meeting. Results Cycle 1, 34 patients: (a) 3KQ 0% (b) appropriate referrals 75% (c) falls risk advice 9%; Cycle 2, 32 patients: (a) 3KQ 50% (b) appropriate referrals 89% (c) falls risk advice 22%. Conclusion This audit shows that a targeted falls risk assessment, completed as part of the CDM reviews, leads to a significant improvement in adherence to international falls guidelines. We suggest that this is a feasible intervention, and recommend the incorporation of a falls risk assessment in the chronic disease management template.