Research Internship with the Person-Centred Complex Care (PCCC) theme

Background: Around 30% of over 65’s, and 50% of over 80’s, will fall at least once a year, costing the NHS 2.3 billion pounds. The World Health Organisation (WHO) has highlighted frailty as a national priority. Locally, A & E attendances due to falls and hip fractures are above average. All health professionals are advised to screen for falls risk. Patients are currently referred to musculoskeletal (MSK) physiotherapy following soft tissue injury or fracture and over 30% of those referred are over 60 years of age. Balance and strength exercises reduce the risk of falls by 25% in patients over 60, up to 34% if added on resistance work. Research has also shown 78% have not done exercises in the last 5 years. This research will help us understand why patients engage or not with their exercises, and if we can adapt our service to meet patient needs.

Research aims and objectives:
• to explore the barriers and facilitators to exercise engagement in patients over 60 at risk of falls,
• to explore the ability of patients over 60 to discuss fall risks with a professional,
• to explore the health inequalities associated with completion of exercise programmes in the local area,
• and to explore the need to develop MSK falls pathways.

Methods: A qualitative study, using semi-structured interviews with up to 10 participants over the age of 60 who are at risk of falls (self-reported unsteadiness, one or more falls in the last 6 months and/or slow or unsteady gait pattern on examination). Interviews will be recorded and transcribed with common themes identified using thematic analysis.

Patient and public involvement: The PPI engagement group identified falls & exercise as an important focus. They reviewed patient facing documents including the patient information leaflet, consent form, and interview schedule for this project. They will contribute to the interpretation of study findings and dissemination.

Potential impact: Understanding why patients do or do not engage with exercise programmes will help with effective service delivery and pathway formation. MSK falls pathway development and better management of falls risk will improve quality of care delivered to patients in MSK, reduce cost and demand on MSK services, and improve patient outcomes.

Links:
• ARC NWC Internship Showcase Poster
• Newsletter (July 2023)

For more information, contact michelle.thirlwall@elht.nhs.uk

Here is Michelle talking about her research.