To evaluate the feasibility and acceptability of a person-centred falls prevention program (Be Your Best) that is tailored to people with OA.
Community-dwelling older adults ≥65 years with a diagnosis of hip and/or knee OA were invited to participate in the Be Your Best program for 6-months. Following consent, participants were assessed remotely via telephone or video-conference and a primary care screening approach was used to determine falls risk and impairments related to OA. Participants chose the modules they wished to engage in, and were guided in goal setting and engagement in preferred community and health services by a trained physiotherapist. Feasibility was assessed by examining recruitment and retention rates as well as any adverse events. Acceptability was assessed by capturing the experiences and views of participants after the program through a customised survey and focus groups. Descriptive statistics were used to profile participant characteristics and report feasibility and acceptability outcomes. Focus group data were analysed using inductive and deductive approaches to generate categories and themes.
Between June and September 2023, 51 participants expressed interest; of these, 28 (55%) were screened for eligibility and 24 (84%) met the criteria. Twenty participants (females 95%; mean age 75 years) consented to the study but one person (5%) withdrew prior to the initial assessment. Overall, 18 participants completed the 6-month program with most electing to use video-conferencing (n=12; 63%). There were no serious adverse events throughout the study; four participants (20%) fell but these were unrelated to the program. All participants reported that the program was relevant and beneficial to their health and wellbeing. Themes emerging from the focus groups indicated that the program improved their knowledge regarding falls and balance with a key facilitator being clinician compassion and the personalised nature of the program. However, participants felt that the remote-delivery mode was a barrier when trying to learn balance exercises.
Our feasibility and acceptability data indicate that we can successfully engage older adults with OA to participate in a remotely-delivered falls prevention program. However, further research is needed to investigate the clinical and cost-effectiveness of this program for people with OA, including exploring the barriers associated with delivering such interventions.
We have shown that a patient-centred falls prevention program that focuses on shared decision-making, goal setting and personalised coaching is feasible and highly acceptable to older adults with hip and/or knee OA. Relationships and trust are crucial when engaging with this population in order to support them to better understand and manage their risk of falling.
osteoarthritis
ageing
