Effectiveness of non-pharmaceutical interventions to prevent falls and fall-related fractures in older people living in residential aged care facilities – a systematic review and network meta-analysis protocol

an eminent public health goal. Evidence on the effectiveness of non-pharmaceutical methods
to prevent falls and fall-related fractures in residential aged care facilities (RACFs) is
unclear. This review aims to assess and rank the effectiveness of the most common fall- and
fracture prevention strategies of non-pharmaceutical nature in RACFs.
Method: This systematic review with network-meta-analysis follows the guidelines from the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P). We
will conduct the systematic literature search across the medical databases MEDLINE, EMBASE,
CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL). We will conduct pairwise
meta-analyses with a random effects model. When appropriate, we will construct a network
graph and conduct network meta-analyses within a Bayesian framework for all outcomes and
interventions. Bayesian network meta-analysis (random effects models) will be used to compare
the relative effectiveness of the different interventions under investigation.
Conclusion: Our review should provide a broader picture of the evidence of benefits and
harms of exercise and other non-pharmaceutical interventions in fall- and fracture prevention
in residents of residential aged care facilities (RACFs). Findings will benefit public and
individual health by contributing in the beneficence of multidisciplinary care of institutionalized
seniors through optimization of fall- and fracture prevention programs.
Registration: Protocol registration: PROSPERO 2018 CRD42018116446; Registration on 28
November 2018.