This pilot tested the methods for a randomised controlled trial (RCT) to investigate the effectiveness of qualified occupational therapists compared to unqualified trained assessors in assessing and modifying the home environment of people at risk of falls. A three armed RCT design was used to pilot the methods for a multi-centre trial and to investigate the effectiveness of occupational therapist (TO) or trained assessor (TA) led environmental assessment compared to a usual care control group.Â Fear of falling was the surrogate primary outcome measure and an analysis of covariance was carried out on the area under the curve at six months.Â Secondary outcome measures (falls and time to first fall) were analysed using negative binomial regression and survival analysis. The intervention had no impact on fear of falling (p=0.6).Â Falls were fewer in the OT and TA groups compared to controls.Â Falls were significantly lower in the OT group, compared to controls, six months post assessment (RR=0.54, 95% Cl: 0.34 to 0.86). Environmental assessment had no impact on fear of falling or falls post randomisation.Â However, professionally prescribed assessment significantly reduced the number of falls and increased time to first fall six months post environmental assessment.Â This result was arrived at through secondary analysis, thus requires further empirical investigation.
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