Grant: Fellowship Award - Primary Care

A relatively recent but significant shift in health research gives credence to outcomes as reported by patients themselves. The BMJ reported the need to complement 'clinical outcomes' with patient reported outcome measures (PROMs) to overcome the case characterized by the cliche that "the operation was a great success, but the patient died." PROMs are assessments of health related quality of life (HRQoL) that may be used to assess medical interventions. The EuroQol-5D (EQ-5D), a generic, widely-used PROM, produces a single summary score based on patients' responses to a question in each of 5 domains -- mobility, usual activities, self care, pain and anxiety/ depression. The EQ-5D's summary score allows comparison of HRQoL across different clinical populations. Despite the increasing appreciation of PROMs in health research, this methodological advance has yet to impact the study of seniors' falls and fall-related injuries. Falls are the 5th greatest cause of death in the US and in Canada, with the direct cost exceeding $1 billion (CAN) annually. My own research puts the global burden of falls at > $23 billion annually. Two CIHR Institutes (Aging, IMHA) include fall prevention within their key research mandates. I propose to use PROMS to examine the association between HRQoL determined from a 12 month period and the clinical characteristics in senior fallers aged 70 years and older. Furthermore, I will assess whether HRQoL at baseline predicts health resource utilisation (HRU) over a 12-month followup period. My study is highly relevant given the magnitude of the burden of falls and the scarcity of PROMs research in this field in Canada. The EQ-5D and falls-related HRU data will enable me to determine which of the comprehensive baseline measures used at the Falls Clinic explain variation in HRQoL and HRU. As such, it will provide important data for policy makers allocating resources for falls prevention.