Fall risk screening improved over time after a provider’s exposure to an intensive fall risk training program as part of a geriatric continuing education curricula for primary care providers, the Geriatric Mini-Fellowship (GMF).
ABSTRACT
Background
Universal fall risk screening as a first step to address falls has been endorsed in primary care but remains challenging due to competing clinical priorities and insufficient training. We studied the impact of our geriatric continuing medical education program, the Geriatric Mini-Fellowship (GMF), on the uptake of fall risk screening in primary care over a 5-year period. We hypothesized that primary care providers (PCP) with exposure to the GMF program would be more likely to implement fall risk screening than PCPs without direct or indirect program exposure.
Population and Setting
We identified 133,068 patients ≥ 65 years of age who received care at primary care clinics in a large health system.
Methods
Each year, we retrospectively assigned patients to one of three groups based on their provider’s exposure to the GMF program. Groups included patients seen by:
GMF providers who completed GMF training.
GMF-influenced providers who practiced at a clinic with at least one GMF provider.
Usual care providers who neither completed GMF training nor worked at a clinic with a GMF provider.
We described fall risk screening rates and patterns using multivariate models to estimate the predicted probability and odds of being screened each year based on a provider’s training exposure.
Results
GMF providers were associated with a greater predicted probability of screening patients for fall risk compared to usual care providers each year. Differences in predicted probabilities between GMF providers and usual care with bootstrapped confidence intervals favored GMF providers. Further, this screening advantage increased over time (2019: 5.8%, 2023: 12%).
Conclusions
Our data supports intensive fall risk education on screening through a geriatrics training program to implement sustained fall risk screening in primary care. Screening is the first step in identifying high-risk patients, which can enable assessment of modifiable risk factors and lead to targeted interventions.