Using a personalized Telehealth model to reduce falls and fracture risk in older adults

IPAN researchers are conducting a world-first trial on the role of telehealth as a new model of personalized healthcare delivery to prevent falls and fractures in older adults.

Falls and fragility fractures result in more days of hospitalization than most other diseases and account for over half of all injury-related healthcare costs in Australia.

Current models of care for fracture prevention focus on pharmaceuticals which reduce fracture risk by 20-50%. However, this approach misses 50-60% of fracture cases in those with osteopenia (low bone density), and has no effect of reducing the risk of falls.

Current best practice clinical guidelines endorse the prescription of regular exercise and nutrition interventions with lifestyle risk factor management to reduce falls and fractures. However, uptake and adherence to traditional community programs is often low/poor, and not personalized to meet individuals’ needs, preferences, financial and social resources.

Digital health technologies (telehealth) offer an equitable, inexpensive and accessible opportunity to meet the needs of a greater number of people at risk of falls and fractures, with the added advantage of being able to deliver personalized programs and information and timely patient-practitioner communication anywhere at any time – a personal health coach in your pocket.

The Telehealth for Falls and Fracture Prevention Implementation Trial (TeleFFIT), funded under the Australian Government’s Medical Research Future Fund, will be led by Professor Robin Daly, Chair in Exercise and Ageing at IPAN.

The trial will involve using digital health as a model of service delivery to reduce falls and fractures in older adults with osteoporosis and/or who are at risk for falls and fractures.

“The TeleFFIT project will offer a personalized, multifaceted, telehealth falls/fracture prevention program to people who are at increased risk in their own homes,” Professor Daly said.

“It will involve a 12-month hybrid effectiveness-implementation trial to evaluate the clinical and cost effectiveness, implementation and potential scalability of the program into ‘real-world’ practice.”

Professor Daly said the intervention is unique as it will be the first to assess a smart device exercise app with personalized behaviour change support, self-directed learning, and nutrition and online peer support to improve self-management behaviours related to common falls/fracture risk factors.

“Findings from this world-first study will fill a critical clinical and practice care gap to guide a personalized, integrated exercise, nutrition and lifestyle risk factor management telehealth model of service delivery that is feasible, cost-effective and with immediate real-world applicability and scalability to reduce the risk of falls/fractures in older people,” Professor Daly said.

This 4-year clinical trial involves a multi-disciplinary team of researchers from across Deakin University in collaboration with the University of Melbourne (Department of Physiotherapy and Department of Medicine and Aged Care), Monash University (Department of Medicine/School of Clinical Sciences at Monash Health) and the University of Waterloo (Department of Kinesiology) in Canada.

The Australian Government’s MRFF provides funding to enable research to look at new approaches to preventative health. The latest round of funding focuses on vulnerable groups, including older adults, with a focus on improving diet, nutrition and physical activity.