69 * SCREENING FOR FALLS AND SYNCOPE RISK FACTORS IN PRIMARY CARE IS CLINICALLY EFFECTIVE: PRELIMINARY EVALUATION OF THE NORTH TYNESIDE FALLS PREVENTION SERVICE (NTFPS)

Abstract

Background: Falls are a major health and health economic burden but case ascertainment remains inadequate. The NTFPS was developed to proactively screen for falls risk factors in primary care. We present data from the Service's first 3 years operation.N = 3308Number%Referred for Dexa following FRAX tool41112.4New cognitive impairment (MMSE<24)1454.4Benign positional paroxysmal vertigo1133.4New atrial fibrillation531.6Orthostatic hypotension1293.9Absolute indication pacemaker170.5Long QTC130.4Vasovagal syncope1163.5New depression (15 item GDS > 10)1173.5Reduced visual acuity/review lenses902.8New murmur962.9High risk FRAX, treat osteoporosis902.7Low BP, culprit meds501.5Asymptomatic bradycardia, culprit meds to reduce621.9Syncope requiring investigations571.7New neurological signs requiring referral351.1Orthopaedic referral suggested- unstable knees/ surgical882.7intervention441.3Orthotist-leg length, foot drop and foot indications2738.3Other126438.2No intervention required by GP199960.4Total significant new diagnosesInnovation: General practice case notes are screened for falls risk factors and syncope for those >60 years and one of:• >4 medications (antihypertensives/ antianginals/ psychoactives)• Fragility fractures• Recurrent falls (≥2 per NICE guidance6)• Blackouts (any in last year, ≥2 in last 2 years)Excluded if known to existing services. Screening questionnaire then sent to clarify risks and invited to attend for comprehensive multidisciplinary assessment per NICE guidelines.Evaluation: Questionnaire response rate was 72%. Total 3308 (28/09/09-13/01/13); Mean age 75.9 years(range 60-100); 2018 (61%) female; 853(25.8%) referred to associated Age UK strength and balance training classesClinical findings and outcomes not previously known to GP:Conclusion: This novel approach pays huge dividends for falls and syncope prevention and bone health. Further work is needed to clarify those at most risk to ensure appropriate resource targeting.