A Qualitative Exploration of Proactive Falls Prevention by Canadian Primary Care Providers

Background: Falls are a growing concern in Canada. Primary care providers are well positioned to address falls risk, but international literature suggests that best-practice guidelines are rarely followed. The objective of this study is to explore the perspectives of Canadian primary care providers around falls prevention and identify solutions. Methods: We conducted one-on-one qualitative interviews with a maximum variation sample of nine primary care providers in Ontario (n=8) and Alberta (n=1) in Canada. Data were collected over telephone and in-person at the location of participants choosing. Audio recordings of the interviews were transcribed, then coded and analyzed with the Behaviour Change Wheel theoretical framework. Results: Most participants reported relying on patient self-report, intuition, and reactive approaches to identifying falls risk. Reported barriers to falls prevention included low capability to gather information on patient history, context, and community resources; limited opportunity to manage patient complexity due to time constraints; and challenges with motivating patients to engage in care plans. Reported facilitators included team-based interprofessional care and provider motivation. Conclusions: This study has found that Canadian primary care providers face barriers to identifying and managing falls risk. These barriers may be rooted in primary care culture, structure, and tradition.