Aims. We were commissioned by the Australian Commission for Safety and Quality in Health Care to update the Australian Fall Prevention Guidelines.
Methods. We updated the Cochrane review[1] on fall prevention in care facilities and hospitals to inform guidance for these settings. We used Cochrane reviews (eg [2]) and the World Falls Guidelines[3] to inform guidance for community settings. We used a modified GRADE approach to assess the certainty of evidence and strength of recommendations.
Results. For fall prevention in hospital we recommend tailored education, personalised multifactorial interventions after assessment, post-operative geriatric orthopaedic care after hip fracture and home safety interventions after discharge. For fall prevention in residential aged care settings we recommend personalised multifactorial interventions after assessment, tailored supervised exercise, menu assessment by dieticians, daily or weekly Vitamin D, bone protective medicines, and hip protectors. For fall prevention in community settings we recommend exercise for all (with a focus on balance and mobility, including strength training), home safety interventions and personalised multifactorial interventions after assessment for higher risk people, and single interventions provided for older people at increased risk of falls with particular risk factors affecting vision, feet, cardiac function, Vitamin D levels and bone health
Conclusions. Implementation and scale-up of these evidence-based recommendations could help address Australia’s rising costs and consequences from falls but is not currently planned, a missed opportunity.