Reducing serious fall-related injuries: an interview with NEJM STRIDE Study author Tom Gill
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
49 min
3 speakers
8 chapters
transcribed 2 days ago
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What motivated the study of fall‑related injuries and how did the researchers become interested in this topic?
The JerryPow podcast is brought to you by Archstone Foundation, preparing society and meeting the needs of an aging population. And now, here are your hosts. Welcome to the Jerry Powell podcast. This is Eric Quadera. This is Alex Smith. And Alex, we have Mr. Disability on our Mr. We have Mr.
Disability. We have Tom Gill, who is professor of medicine and geriatrics and director in the pro of the program on aging and the director of the Pepper Center at the Yale School of Medicine. This is his second appearance on the Jerry Pell Podcast. Welcome back to the Jerry Pell Podcast, Tom.
Thank you, Alex. Thank you, uh, Eric. I'm delighted to have a second chance.
We're gonna be talking about your New England Journal of Medicine study, uh the randomized trial of a multifactorial strategy to prevent serious fall injuries or the stride study. But before we do that Do you have a side request for Alex?
Right. I had selected Uh losing my religion by REM. I No, you want a story about that. Uh, but I you know had lots of uh CD ROM or CDs back in the late eighties and early nineties. Uh and I transferred them all onto my uh MacBook. Um and that's how I listen to my music is on my MacBook and I have them they're all lined up and I was just happened to be around the REM. Uh I have a couple of their albums or or CDs and uh I thought, oh that would be a a good choice. And then I listened to songs and and gave Alex a few uh options and I think we settled on losing my religion. I just like the melody. and uh and and the lyrics.
Mm-hmm. This is a great one for people to sick sing along if you're listening in the car. Sing along. It also has a maybe a little bit about falls. Consider this the slip that brought me to my knees failed. Maybe a tenuous connection?
Yeah, I didn't catch that, but uh I commend you for
Here's a little bit.
Uh line. It's bigger Bigger than you and you are not me The lengths that I will go to A distance in your eyes Oh no, I've said too much. A serera That's me in the corner. That's me in the spot, like losing my religion. Trying to keep up with you. And I don't know if I can do it. Oh no I've said too much. Haven't said enough. That I heard you laughing. I thought that I heard you sing. I think I thought I saw you try
And more later. Excellent. Love REM. Love REM. Great choice. Thank you.
So let's jump into it. Um the stride study. First of all, congratulations um on the study for you and your colleagues. This was this was huge. Before we get into the study, like how did you get interested in the the topic of falls and and you know starting to think about like interventions for it?
Right. Well my longstanding mentor, Mary Tinetti, is like the world's expert on falls and you know she done Done most of the seminal epidemiologic work and and that led to intervention research in a more traditional efficacy study and she demonstrated the the benefit of a multifactorial approach to preventing falls. It was a relatively small study. The results were Published in New England Journal in the 90s, but she didn't have sufficient power to look at injuries. And then she followed that up with a a state-based study in which she divided Connecticut into two parts, uh implemented a similar intervention, more in a real-world setting. Um and that demonstrated benefit uh with about a reduction of of eight percent in serious foul injuries, but it wasn't a
randomized trial. Um so Pacori um released um an RFA. This was made it to their top list in terms of priorities.
What did earlier fall‑prevention research (Mary Tinetti’s work and state‑based studies) reveal about multifactorial interventions?
Um and And I was part of a a group that responded to this RFA. Um, I think at that point Mary um had You know, moved on. to other Research endeavors. Um so she left us uh you know to pursue the opportunity that was presented by Piccore.
It's great. And we should welcome Ken Kavinsky back to the podcast. Ken, uh, how are you doing? Hi. Good to see
you all. Hi, Tom. I can not a good night last night. No, it was not. You can't we can't we can't lose to the worst team in baseball. What what what is the Cubs record right now?
Uh and there's something like eighteen and twelve or something like that.
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Chapters
8 chapters
1
What motivated the study of fall‑related injuries and how did the researchers become interested in this topic?
0:01–5:02
2
What did earlier fall‑prevention research (Mary Tinetti’s work and state‑based studies) reveal about multifactorial interventions?
5:02–11:02
3
How was the STRIDE trial designed – who were the participants, what were the inclusion criteria, and how many sites were involved?
11:02–17:17
4
What did the “falls care manager” intervention consist of – which risk factors were assessed and what components were offered?
17:17–23:50
5
What were the primary and secondary outcomes of the STRIDE study and how were serious fall injuries defined and adjudicated?
23:50–29:48
6
Why did the trial show only a modest (≈0.4%) difference in serious fall injuries and was it statistically significant?
29:48–36:06
7
How should clinicians interpret these results – does a small effect still justify multifactorial fall‑prevention in practice?
36:06–42:53
8
What are the next steps for fall‑prevention research – should future studies focus on broader outcomes like well‑being or caregiver burden?
42:53–49:34
Speakers
3 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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