Clinical Research Directory

SAFER Karachi - A Fall Prevention Intervention

The goal of this pilot study is to evaluate the feasibility, acceptability, and short-term effects of a culturally adapted and strengthened fall prevention program in older adults aged 60 years and above living in urban Karachi, Pakistan. The study aims to understand whether a structured, community-based intervention can improve mobility, confidence, and overall well-being, while reducing the risk of falls. The main questions it aims to answer are: 1. Is the adapted and strengthened fall prevention program feasible and acceptable for older adults in Karachi? 2. Does participation in the program improve mobility, balance, fall-related self-efficacy, and emotional well-being among participants? Participants will: 1. Take part in a 7-week group-based fall prevention program that includes strength and balance exercises, home safety education, medication awareness, and behavioural strategies 2. Receive a follow-up home visit to reinforce safety practices and environmental modifications 3. Attend a booster session after 3 months to support continued engagement 4. Complete assessments at baseline and follow-up, including mobility, cognitive function, quality of life, and emotional well-being 5. Maintain monthly fall logs to report any fall incidents during the study period

Duke Virtual IntEgrated Workflow

This quality improvement initiative aims to evaluate the implementation, utilization, and impact of virtual care technologies and workflows being implemented at Duke University Health System (DUHS). This project is embedded within operational workflows and is designed to inform strategic decision-making and resource allocation. The evaluation will focus on key performance indicators (KPIs) relevant to hospital operations and patient outcomes, including but not limited to: Length of Stay, Readmission Rates, Patient Satisfaction Scores, and Other Quality and Safety Metrics. These KPIs will be evaluated across three clinical units at Duke University Hospital, in which virtual care technologies are being implemented. These will be compared to three control units of similar characteristics. Differences in KPIs will be examined across all units over 12 months.

EXpress Prevent Rural oldEr Adults' fallS, fractureS and Dependency (EXPRESS)

Falls are the leading cause of injury-related death among individuals aged 65 and above in China. The incidence of falls shows a significant urban-rural disparity in China, with rural areas experiencing a markedly higher rate than urban regions. However, a systematic fall prevention strategy tailored to the needs of older people in rural China has not yet been established. The EXPRESS study is a multicenter, cluster-randomized controlled trial designed to explore the effectiveness and health economic evaluation of an AI-assisted, village doctors and express services-involved, personalized fall screening and prevention strategy based on multidimensional risk profiling in reducing the incidence of falls and fall-related injuries among older people in rural China. A total of 1,881 older individuals from 16 villages across four provinces in China (with four villages per province) will be recruited. These 16 rural areas will be randomly assigned to either the intervention group or the control group. The intervention group will receive the AI-assisted, village doctors and express services-involved personalized fall prevention strategy based on multidimensional fall risk screening and assessment, while the control group will follow routine primary health management practices. The intervention period will last for one year, with randomization taking place after the baseline survey. The primary outcomes are the incidence of falls and fall-related injuries (including falls resulting in hospitalization and fractures, etc). Secondary outcomes include activity of daily living, quality of life, fall-related health literacy, depressive symptoms, cognitive function, dementia, physical function and performance, incidence of chronic non-communicable diseases, frailty, and sleep quality.