National clinical audit for hospitalised exacerbations of COPD.

Introduction: Exacerbations of COPD requiring hospital admission are burdensome to patients and health services. Audit enables benchmarking performance between units and against national standards, and supports quality improvement. We summarise 23 years of UK audit for hospitalised COPD exacerbations to better understand which features of audit design have had most impact.

A multicentre randomised controlled trial of day hospital-based falls prevention programme for a screened population of community-dwelling older people at high risk of falls.

Objective: to determine the clinical effectiveness of a day hospital-delivered multifactorial falls prevention programme, for community-dwelling older people at high risk of future falls identified through a screening process.

Design: multicentre randomised controlled trial.

Setting: eight general practices and three day hospitals based in the East Midlands, UK.

The national clinical audit of falls and bone health: the clinical management of hip fracture patients.

Background: The standards of care for older people who present with a fractured neck of femur (#NOF) have been defined by previously published national guidelines. To assess compliance with these standards the Healthcare Commission commissioned the Clinical Effectiveness and Evaluation Unit (CEEU) for the Royal College of Physicians to deliver 'The National Clinical Audit of Falls and Bone Health for Older People'.

Methods: The audit was developed by a multi-disciplinary team using available best evidence to set audit standards.

Multifactorial day hospital intervention to reduce falls in high risk older people in primary care: a multi-centre randomised controlled trial [ISRCTN46584556].

Falls in older people are a major public health concern in terms of morbidity, mortality and cost. Previous studies suggest that multifactorial interventions can reduce falls, and many geriatric day hospitals are now offering falls intervention programmes. However, no studies have investigated whether these programmes, based in the day hospital are effective, nor whether they can be successfully applied to high-risk older people screened in primary care.

Reproducibility of circulatory changes to head-up tilt in healthy elderly subjects.

Objective: to assess the reproducibility of the cardiovascular responses to head-up tilt including cardiac output, stroke volume and peripheral resistance, in healthy older subjects using non-invasive methods.

Participants: twenty-five healthy community-dwelling volunteers with a mean age of 69+/-3 years.

Methods: the subjects underwent head-up tilt table testing on two occasions at an interval of 6 weeks.