A randomized controlled trial to evaluate innovative decision support in the context of fall prevention

L. Westerbeek; A. J. Linn; H. C. van Weert; N. van der Velde; S. Medlock; A. Abu-Hanna; J. C. M. van Weert

doi:10.1038/s41746-025-01822-9

A randomized controlled trial to evaluate innovative decision support in the context of fall prevention

L. Westerbeek^*, A. J. Linn, H. C. van Weert, N. van der Velde, S. Medlock, A. Abu-Hanna, J. C. M. van Weert

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Falls are a major cause of injuries among older people, with medication being a key risk factor. The SNOWDROP intervention introduces a clinical decision support system for general practitioners (GPs) offering personalized deprescribing advice, and a patient portal containing information and a question prompt list. This study evaluates the intervention’s effectiveness through a cluster randomized controlled trial in six general practices, with 84 patients (M_age = 78.01, SD_age = 5.71). Patients discussed their medication-related fall risk with their GP. Data were collected via questionnaires and audio-recorded consultations. The intervention increased shared decision-making for both GPs (p < 0.001) and patients (p < 0.001), increased patients’ satisfaction with communication (p = 0.001), and reduced patients’ decisional conflict (p < 0.001). Patients’ beliefs about medication (necessity and concerns) remained stable. The effect on changes to the medication was inconclusive. These results highlight the potential of technology in healthcare and warrant future research.

Original language	English
Article number	431
Journal	npj Digital Medicine
Volume	8
Issue number	1
DOIs	https://doi.org/10.1038/s41746-025-01822-9
Publication status	Published - 1 Dec 2025

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title = "A randomized controlled trial to evaluate innovative decision support in the context of fall prevention",

abstract = "Falls are a major cause of injuries among older people, with medication being a key risk factor. The SNOWDROP intervention introduces a clinical decision support system for general practitioners (GPs) offering personalized deprescribing advice, and a patient portal containing information and a question prompt list. This study evaluates the intervention{\textquoteright}s effectiveness through a cluster randomized controlled trial in six general practices, with 84 patients (Mage = 78.01, SDage = 5.71). Patients discussed their medication-related fall risk with their GP. Data were collected via questionnaires and audio-recorded consultations. The intervention increased shared decision-making for both GPs (p < 0.001) and patients (p < 0.001), increased patients{\textquoteright} satisfaction with communication (p = 0.001), and reduced patients{\textquoteright} decisional conflict (p < 0.001). Patients{\textquoteright} beliefs about medication (necessity and concerns) remained stable. The effect on changes to the medication was inconclusive. These results highlight the potential of technology in healthcare and warrant future research.",

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AU - Medlock, S.

AU - Abu-Hanna, A.

AU - van Weert, J. C. M.

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A randomized controlled trial to evaluate innovative decision support in the context of fall prevention

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