These recommendations are based on the National Collaborating Centre for Nursing and Supportive Care guideline, Clinical practice guideline for the assessment and prevention of falls in older people [National Collaborating Centre for Nursing and Supportive Care, 2004], and were based on evidence from a Cochrane systematic review that has now been withdrawn and replaced by two reviews, Interventions for preventing falls in older people living in the community [Gillespie et al, 2009] and Interventions for preventing falls in older people living in residential care facilities and hospitals (nearing completion).

• The guideline does not give specific information on what a falls service should offer to an individual identified at risk of falling. However, the guideline does state that a personalised approach should be carried out, and management should be focused around strength and balance training, home hazard and vision assessment and intervention, and medication review.
• Evidence from the recently published Cochrane systematic review indicates that:
• Exercise interventions reduce the rate and risk of falls.
• Further research is required to clarify the contexts in which multifactorial interventions, home safety interventions, and vitamin D supplementation are effective.
• There is limited evidence to support the withdrawal of psychotropics and GP educational programmes plus medication review for reducing falls.
• For people with poor vision, there is evidence (from one study) that cataract surgery on the first eye is effective at reducing the rate of falls.
• For people with carotid sinus hypersensitivity, there is evidence (from one study) that a pacemaker s effective at reducing the rate of falls.