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Table 2 Study instruments and timeline of assessments

From: GAPcare: the Geriatric Acute and Post-acute Fall Prevention Intervention—a pilot investigation of an emergency department-based fall prevention program for community-dwelling older adults

Instrument Description Administration
Process evaluation
 Screening, eligibility, and retention • Records how many patients were screened, agreed to participate, were recruited, received intended treatment, and were retained • Baseline, 180 days
 ED component and fidelity • Records index visit ED LOS, time between consult call and arrival of pharmacist and PT, length of each consult, accuracy and completeness of action plan compared to the protocol • Baseline
 Patient, caregiver, and clinician feedback • Tracks satisfaction with each component of the evaluation, perceived barriers and facilitators, and collects suggestions for improvement of the intervention • Baseline
 Follow-up component • Tracks follow-up phone and in-person sessions with the research staff, PT, and any home services. Records uptake of recommendations made on the action plan for intervention participants • 30, 90, 180 days
Outcome evaluation—feasibility, fidelity, and initial efficacy
 Enrollment questionnaire • Demographic characteristics (includes marital status, whether the patient lives alone or with others, educational attainment, current employment.)
• Prior fall history, comorbidities, ED index visit fall circumstances, and injuries
• Baseline
• < 5 min
 Six-Item Screener (SIS) [19] • 6-point questionnaire to measure cognitive impairment for study screening [19], < 4 indicates high risk for cognitive impairment • Baseline
• 2 min
 Timed Up and Go (TUG) test [21] • Timed test of how long it takes the patient to get up from a chair, walk 10 feet, and return to the chair
• Validated measure of current function, balance, and fall risk
• A TUG > 12 seconds identifies those patients at greater risk for subsequent falls
• Baseline, 180 days
• < 5 min
 Barthel Index for Activities of Daily Living (ADL) [22] • Used to assess functional independence [22]
• Information can be gained by self-report or caregiver report
• Baseline, 30, 90, 180 days
 Tinetti [23] • Validated measure of gait and balance
• Predicts falls
• Baseline
• < 5 min
 5 Times Sit to Stand [24] • A measure of functional lower limb muscle strength • Baseline
 AM-PAC “6-clicks” • Test of activity limitations and function [25] used to help determine need and intensity of outpatient services such as PT, safety of discharge, and to predict falls and healthcare utilization • Baseline
• 1 min
 Falls Efficacy Scale-International [26] • Measures fear of falling, which increases fall risk • 180 days
 Medication questionnaire • Records all current and new prescriptions, over-the-counter and herbal medication, recommendations made by the pharmacist, recommendations accepted by the patient, and date of initiation/cessation • Baseline, 180 days
• 25 min
 Outcome instrument • Records follow-up falls and injuries by self-report and EHR review
• Records subsequent ED visits and hospitalizations
• 30, 90, 180 days
• 5 min
  1. ED emergency department, LOS length of stay, SIS Six-Item Screener, TUG Timed Up and Go, ADL Activities of Daily Living, PT physical therapy, AM-PAC Activity Measure for Post-Acute Care, EHR electronic health record