Telemedicine-based STEADI implementation showed no difference in self-reported falls among older adults compared to standard care

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The Gerontologist Published May 12, 2026 Medically reviewed May 12, 2026 Study authors: Haddad Yara K, Brault Matthew W, Moreland Briana, Peterson Cora, Zhang Xinjian, Thomas Karen, Sublet… PubMed ↗ DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Note no significant difference in self-reported falls between telemedicine STEADI and standard care in older adults.

This randomized controlled quality improvement trial enrolled 660 older adults aged 65 years and above in primary care settings. Participants were assigned to receive either telemedicine-based STEADI implementation or standard-of-care. The intervention involved fall risk assessment by a research nurse, STEADI-based recommendations shared with primary care physicians, and recommended interventions administered at the discretion of the physicians.

The primary outcome was self-reported falls. Overall, 5.5% of participants reported a fall in the past 12 months. No significant differences were observed between the intervention and comparator groups for this primary outcome. Secondary outcomes included medically treated falls, fall-related service utilization, and medication changes. No significant differences were observed between groups for medically treated falls, with an odds ratio of 0.741 and a 95% CI of 0.411-1.336.

Safety and tolerability data were not reported in this trial. Key limitations included limited recruitment, low baseline fall rates, and unmeasured adherence. The study did not report adverse events, serious adverse events, discontinuations, or specific tolerability metrics. These factors may influence the interpretation of the results regarding the intervention's real-world impact.

Practice relevance is tempered by the need for further research to evaluate the feasibility and effectiveness of telemedicine-based STEADI interventions in primary care. The findings do not establish causation, and the results should be interpreted with caution given the study design and limitations.

Study Details

Study typeRct

Sample sizen = 660

EvidenceLevel 2

Follow-up780.0 mo

PublishedMay 2026

PMID41349283

View Original Abstract ↓

BACKGROUND AND OBJECTIVES: Falls are a leading cause of injury and death among older adults (65 years and above). The Centers for Disease Control and Prevention's Stopping Elderly Accident, Deaths, and Injuries (STEADI) initiative aims to reduce falls by screening to find at-risk individuals, evaluation, and then addressing modifiable risk factors. This study evaluated the effectiveness of implementing a STEADI-based multi-component fall prevention approach via telemedicine in primary care. RESEARCH DESIGN AND METHODS: A randomized controlled quality improvement trial (STEADI Options) was conducted during the COVID-19 pandemic (July 2020-December 2021). Primary care professionals (PCPs) were randomized to either standard-of-care (SOC) or intervention. The intervention included a fall risk assessment by a research nurse, who shared STEADI-based recommendations with PCPs. Recommended interventions were administered at the discretion of PCPs. Outcomes included self-reported falls (primary), medically treated falls, fall-related service utilization (physical therapy, occupational therapy, eye care, podiatry), and medication changes, assessed over one year. Analyses followed an intent-to-treat approach. RESULTS: Among 660 participants (353 SOC; 307 intervention), the cohort was predominantly female (67.7%), aged 65-79 years (73.6%), and non-Hispanic White (56.1%). Intervention participants had higher average Stay Independent Screener (SIS) scores (6.3 vs. 5.2; p < 0.001). Overall, 5.5% reported a fall in the past 12 months. No significant differences were observed between groups in fall-related outcomes (e.g., medically treated falls odds ratio [adjusted for SIS]: 0.741; 95% CI: 0.411-1.336). DISCUSSION AND IMPLICATIONS: Although no significant differences were found, limited recruitment, low baseline fall rates, and unmeasured adherence may have impacted results. Further research is needed to evaluate the feasibility and effectiveness of telemedicine-based STEADI interventions in primary care.