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Exploring clinicians’ perspectives on falls, balance and gait assessments to inform wearable device development. “Adding to the bigger picture of the patient in falls assessments”

IntroductionFalls represent a major healthcare burden with significant costs to healthcare systems as well as individual patients. Falls assessments are complex, multifactorial and often involve input from multiple specialists. Collecting data to contribute to these assessments is typically done by clinical history and examination. Wearable monitoring systems that are capable of recording patient-specific data related to falls and falls risk factors may represent a rich source of information for patients and clinicians to inform their assessment and treatment plans. Here we present the findings of multimodal qualitative study that aimed to identify clinicians’ perspectives on key features of falls assessments as well as the potential utilisation of wearable monitoring devices in the field of falls and falls assessments. Our findings inform device developers and ensure monitoring systems are designed with the end-users in mind.MethodsWe used a multimodal qualitative study design. Survey responses from 26 healthcare practitioners (geriatricians, physiotherapists, falls prevention practitioners, and primary care physicians) were analysed using a reflexive thematic approach. Semi-structured interviews with practitioners were also conducted facilitating deeper analysis of the identified themes.Results and discussionSix overarching themes were identified: “History of falls is key”, “Ecologically valid data”, Multidisciplinary approach, “Data that helps”, “Data causes anxiety”, and “Wearable literacy”. Exploration of these indicated that, if developed appropriately, wearable devices could support the clinical assessment and management of patients at risk of falls by providing ecologically valid, temporaneous and objective data related to modifiable risk factors of falls. This study outlines key priorities in falls assessment from clinicians’ perspectives to inform device developers and highlight how a collaborative approach, engaging with clinicians, is necessary to facilitate development and integration of devices into patient pathways in a manner that is acceptable and useful to key stakeholders.

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