Table 1 Eligibility criteria for key question 1

Population

Adults living in the community, aged 65 or older.

Community living consists of living at home or in independent living/retirement facilities where no or minimal assistance (e.g., help with one activity of daily living [ADL; e.g. bathing] or Instrumental ADL, e.g. cooking) is provided

Studies recruiting adults living in the community under the age of 65 may be included if ≥ 80% of the participants are aged 65 or older. If the proportion of the participants aged 65 or older is not available, studies may be included if the participants’ mean age minus one standard deviation is equal to or greater than 65.

Studies with recruitment based exclusively on one or more specific diagnoses. Excluded populations include, but are not limited to:

• Stroke

• Parkinson’s (neurodegenerative conditions)

• Severe dementia (will include if all mild-to-moderate cognitive impairment)

• Long-term care facilities

• Housebound

• Severe frailty (with protocol for addressing falls or for falls risk assessment in place)

• Impaired balance (severe)

• Community-dwelling and receiving long-term, intensive nursing care

• Visual impairment (severe)

• Hospitalized patients

• Acute fracture

• Confirmed vitamin D deficiency

Interventions

Single component, multiple component or multifactorial interventions in which the primary objective is to prevent falls.

Intervention components that can be classified using the ProFANE Taxonomy (Table 2).

Interventions that cannot feasibly or readily be delivered or referred to by a wide variety of primary care providers (see exclusions in Table 2).

Interventions that are not directly focused on the cascade of falls (i.e., falls prevention must be primary aim of intervention).

Single interventions that are exclusively screening/assessment tools and/or quality improvement (“add-on”) strategies.

Comparator

• Usual care (e.g., no additional care focusing on falls; may include wait-list, attention control, pamphlet or generic health education, placebo)

• Non- or minimally active intervention (e.g., brief pamphlet on falls risk, social visits)

• Another intervention to prevent falls; for critical outcomes where NMA is conducted only, and if classified differently according to ProFANE taxonomy and our coding

Outcomes

Critical

• Falls (i.e., total number of falls per unit of person-time)

• Fallers (i.e., number of people falling one or more times during follow-up)

• Injurious falls (one used per study using a hierarchy: falls leading to hospitalization, falls requiring emergency department visit, falls requiring physician visit, any injurious fall); preferentially the number of people with one or more injurious falls, but will include total number if necessary

• Fractures (only fall-related, if reported; preferentially the number of people with one or more fractures, but will include total number if necessary)

• Hip fractures (only fall-related, if reported)

• Residential status/institutionalization (number of people newly admitted to residential care)

• Health-related quality of life (validated scales, e.g., SF-12 and/or SF-36 Physical and Mental Components, EQ 5D VAS, EuroQol EQ-5D)

• Functional status: (i) validated scales including activities of daily living and instrumental ADLs [composite scores only], (ii) number of people with new/increased need for homecare assistance; (iii) other validated scales will be considered

Important

• Intervention-related adverse effects (AEs) as defined by study (people experiencing one or more AEs; individual serious AEs)

Timing

Follow-up duration: ≥ 3 months after randomization

Delivery Setting

Any relevant to primary care (primary care, community [home or other]).

Interventions can be initiated in the emergency department, but cannot be entirely delivered in the emergency department.

Settings not relevant to primary care and targeting general community-dwelling population (e.g., workplaces, inpatient settings, specialist settings, interventions entirely delivered in the emergency departments, nursing/long-term care homes).

Study design

Randomized controlled trials (all designs including parallel, cluster, crossover, multifactorial)

• Editorials

• Commentaries

• Studies only published/available as conference proceedings, letters, or other gray literature (e.g., government reports), unless information on study design (e.g., eligibility criteria, participant characteristics, intervention characteristics) is described sufficiently and results are confirmed as final (accessible online or via author contact)

Language of full text

English or French

Dates of publication

Any