Developing and evaluating complex healthcare interventions in geriatrics: The use of the medical research council framework exemplified on a complex fall prevention intervention

Journal of the American Geriatrics Society

Volumn 58, Issue 11, 2010, Pages 2212-2221

  Faes, Miriam C ^a   Reelick, Miriam F ^a   Esselink, Rianne A ^a   Rikkert, Marcel G Olde ^a  

^a RADBOUD UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

complex interventions; development; evaluation; frail older persons; MRC framework

Indexed keywords

BEHAVIOR CHANGE; CLINICAL EFFECTIVENESS; CLINICAL EVALUATION; COGNITIVE THERAPY; CONCEPTUAL FRAMEWORK; COST EFFECTIVENESS ANALYSIS; FALLING; FEASIBILITY STUDY; FOLLOW UP; FUNDING; GENERALIZED ANXIETY DISORDER; GERIATRIC CARE; HEALTH CARE QUALITY; HEALTH CARE SURVEY; HUMAN; INFORMATION DISSEMINATION; INTERVENTION STUDY; MINI MENTAL STATE EXAMINATION; MONITORING; OUTCOME ASSESSMENT; PATIENT COMPLIANCE; PILOT STUDY; PREVENTION STUDY; PROCESS DEVELOPMENT; QUALITY CONTROL; RANDOMIZATION; REVIEW; SAMPLE SIZE; TREATMENT PLANNING;

ACCIDENTAL FALLS; AGED; GERIATRICS; GREAT BRITAIN; HEALTH SERVICES FOR THE AGED; HEALTH SERVICES RESEARCH; HUMANS;

EID: 78449289221     PISSN: 00028614     EISSN: 15325415     Source Type: Journal    
DOI: 10.1111/j.1532-5415.2010.03108.x     Document Type: Review

References (47)

1. A framework for development and evaluation of RCTs for complex interventions to improve health 2000. Medical Research Council [on-line]. Available at Accessed February 2007.
2. Vliek S, Melis RJ, Faes M,. Single versus multicomponent intervention in frail elderly: Simplicity or complexity as precondition for success? J Nutr Health Aging 2008; 12: 319-322.
3. Developing and evaluating complex interventions: New guidance 2008. Medical Research Council [on-line]. Available at Accessed November 1, 2008.
4. Boutron I, Moher D, Altman DG,. Methods and processes of the CONSORT Group: Example of an extension for trials assessing nonpharmacologic treatments. Ann Intern Med 2008; 148: W60-W66.
5. Craig P, Dieppe P, Macintyre S., Developing and evaluating complex interventions: The new Medical Research Council guidance. BMJ 2008; 337: a1655.
6. Harari D, Hopper A, Dhesi J,. Proactive care of older people undergoing surgery ("POPS"): Designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients. Age Ageing 2007; 36: 190-196.
7. Redfern J, McKevitt C, Wolfe CD., Development of complex interventions in stroke care: A systematic review. Stroke 2006; 37: 2410-2419.
8. Sampson EL, Thune-Boyle I, Kukkastenvehmas R., Palliative care in advanced dementia; A mixed methods approach for the development of a complex intervention. BMC Palliat Care 2008; 7: 8.
9. Gillespie LD, Robertson MC, Gillespie WJ., Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2009;(2):CD007146.
10. Shaw FE., Prevention of falls in older people with dementia. J Neural Transm 2007; 114: 1259-1264.
11. Tinetti ME, Kumar C., The patient who falls: "It's always a trade-off." JAMA 2010; 303: 258-266.
12. Campbell NC, Murray E, Darbyshire J., Designing and evaluating complex interventions to improve health care. BMJ 2007; 334: 455-459.
13. Campbell M, Fitzpatrick R, Haines A., Framework for design and evaluation of complex interventions to improve health. BMJ 2000; 321: 694-696.
14. Eldridge S, Spencer A, Cryer C., Why modeling a complex intervention is an important precursor to trial design: Lessons from studying an intervention to reduce falls-related injuries in older people. J Health Serv Res Policy 2005; 10: 133-142.
15. Mody L, Miller DK, McGloin JM., Recruitment and retention of older adults in aging research. J Am Geriatr Soc 2008; 56: 2340-2348.
16. Guidance for reporting qualitative research. Enhancing the QUAlity and Transparency of health Research (EQUATOR) network [on-line]. Available at Accessed February 2007.
17. Qualitative research. BMJ [on-line]. Available at Accessed February 2007.
18. Behaviour change at population, community and individual levels 2007. National Institute for Health and Clinical Excellence. Available at Accessed October 2007.
19. Hardeman W, Sutton S, Griffin S., A causal modelling approach to the development of theory-based behaviour change programmes for trial evaluation. Health Educ Res 2005; 20: 676-687.
20. Fried LP, Tangen CM, Walston J., Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56A: M146-M156.
21. Folstein MF, Folstein SE, McHugh PR., "Mini-mental state." A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198.
22. Tinetti ME, Richman D, Powell L., Falls efficacy as a measure of fear of falling. J Gerontol 1990; 45: P239-243.
23. Scheffer AC, Schuurmans MJ, Van Dijk N., Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 2008; 37: 19-24.
24. Van Iersel MB, Verbeek AL, Bloem BR., Frail elderly patients with dementia go too fast. J Neurol Neurosurg Psychiatry 2006; 77: 874-876.
25. Delbaere K, Crombez G, Van Den NN., The risk of being fearful or fearless of falls in older people: An empirical validation. Disabil Rehabil 2006; 28: 751-756.
26. Arfken CL, Lach HW, Birge SJ., The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health 1994; 84: 565-570.
27. Li F, Fisher KJ, Harmer P., Fear of falling in elderly persons: Association with falls, functional ability, and quality of life. J Gerontol B Psychol Sci Soc Sci 2003; 58B: 283-290.
28. Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001; 49: 664-672.
29. Chang JT, Morton SC, Rubenstein LZ., Interventions for the prevention of falls in older adults: Systematic review and meta-analysis of randomised clinical trials. BMJ 2004; 328: 680.
30. Feder G, Cryer C, Donovan S., Guidelines for the prevention of falls in people over 65. The Guidelines' Development Group. BMJ 2000; 321: 1007-1011.
31. Gates S, Fisher JD, Cooke MW., Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: Systematic review and meta-analysis. BMJ 2008; 336: 130-133.
32. Shaw FE, Kenny RA., Can falls in dementia be prevented? Age Ageing 1998; 27: 7-9.
33. Zijlstra GA, Van Haastregt JC, Van Rossum RE., Interventions to reduce fear of falling in community-living older people: A systematic review. J Am Geriatr Soc 2007; 55: 603-615.
34. Mohlman J, Gorman JM., The role of executive functioning in CBT: A pilot study with anxious older adults. Behav Res Ther 2005; 43: 447-465.
35. Lamb SE, Jorstad-Stein EC, Hauer K., Development of a common outcome data set for fall injury prevention trials: The Prevention of Falls Network Europe consensus. J Am Geriatr Soc 2005; 53: 1618-1622.
36. Kempen GI, Yardley L, Van Haastregt JC., The Short FES-I: A shortened version of the Falls Efficacy Scale-International to assess fear of falling. Age Ageing 2008; 37: 45-50.
37. Graff MJ, Vernooij-Dassen MJ, Thijssen M., Community based occupational therapy for patients with dementia and their care givers: Randomised controlled trial. BMJ 2006; 333: 1196.
38. Yardley L, Bishop FL, Beyer N., Older people's views of falls-prevention interventions in six European countries. Gerontologist 2006; 46: 650-660.
39. Sherrington C, Whitney JC, Lord SR., Effective exercise for the prevention of falls: A systematic review and meta-analysis. J Am Geriatr Soc 2008; 56: 2234-2243.
40. Zijlstra GA, Van Haastregt JC, Ambergen T., Effects of a multicomponent cognitive behavioral group intervention on fear of falling and activity avoidance in community-dwelling older adults: Results of a randomized controlled trial. J Am Geriatr Soc 2009; 57: 2020-2028.
41. Ferrucci L, Guralnik JM, Studenski S., Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: A consensus report. J Am Geriatr Soc 2004; 52: 625-634.
42. Reelick MF, Faes MC, Lenferink A., The fall telephone for falls assessment in frail older persons; feasibility, reliability, and validity. J Am Geriatr Soc in press.
43. Clemson L, Cumming RG, Kendig H., The effectiveness of a community-based program for reducing the incidence of falls in the elderly: A randomized trial. J Am Geriatr Soc 2004; 52: 1487-1494.
44. Melis RJ, Van Eijken MI, Teerenstra S., A randomized study of a multidisciplinary program to intervene on geriatric syndromes in vulnerable older people who live at home (Dutch EASYcare Study). J Gerontol A Biol Sci Med Sci 2008; 63: 283-290.
45. Graff MJ, Adang EM, Vernooij-Dassen MJ., Community occupational therapy for older patients with dementia and their care givers: Cost effectiveness study. BMJ 2008; 336: 134-138.
46. Inouye SK, Studenski S, Tinetti ME., Geriatric syndromes: Clinical, research and policy implications of a core geriatric concept. J Am Geriatr Soc 2007; 55: 780-791.
47. Jones J, Hunter D., Consensus methods for medical and health services research. BMJ 1995; 311: 376-380.