Older Adults (65 Years and Older)Anti-HI-FallsNCT07111871
Healthcare Services for Older People Who Have Fallen With Potential Head Injury
An observational study of Older Adults (65 Years and Older) and Falls, run by Portsmouth Hospitals NHS Trust at 1 site in United Kingdom.
Trial summary
Every year, one in three older people (>65 years old) experience a fall. Older people may have long-term health conditions and take medications that can increase their risk of bleeding (blood thinners). Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Older Adults (65 Years and Older), Falls, Head Injury
- How many people
- 1,000 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- 11 Sep 2025to 10 Nov 2025
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: This study is a cross-sectional mixed-methods online survey involving NHS healthcare professionals working in HIOW ICS across all relevant sectors. This could include those working in (but not limited to): * Acute hospitals including ED, Acute Medical Unit, Older Persons/Geriatric departments, Same Day Emergency Care services * Primary care services including out of hours * Community health services (urgent community response services, acute frailty wards, hospital at home, urgent treatment centres) * South Central Ambulance Services (SCAS) and 111 emergency services
Who may be able to join
- • Aged 18 years or above
- Healthcare professional whose primary employment is within HIOW
- Have experience reviewing older adults on anticoagulant or antiplatelet medications who have had a fall as part of their job role
- Confirmed consent to participate on the completed survey
Who cannot join
- • Did not consent to participate on the completed survey
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
Portsmouth Hospitals University NHS Trust
Portsmouth
About this study
Official title: Understanding Care Pathways for Older People on Anticoagulant or Antiplatelet Medications With Falls and Head Injury
Every year, one in three older people (>65 years old) experience a fall. Older people may have long-term health conditions and take medications that can increase their risk of bleeding (blood thinners). The UK national guidelines recommend that older people who are on blood thinning medications should have a CT head scan considered due to concerns of a brain bleed if they have hit their head after a fall. Many older people are therefore brought into hospital for assessment. However, the risk of bleeding in the brain is very low especially if older people do not have any symptoms such as loss of consciousness, weakness, headaches or vomiting. Some people could experience long waits in the emergency department or end up being admitted to hospital unnecessarily. This could worsen mobility, cause confusion, pressure sores or infections in older people.
More importantly, older people should have a comprehensive falls assessment to reduce their risk of future falls and have their medications reviewed after experiencing a fall. These assessments could potentially take place in their own homes if they prefer, rather than in hospital. Yet, current healthcare services outside the hospital setting may not be set up to manage an older person after fall.
Read more
Using an online survey, the investigators want to understand how current healthcare services in the Hampshire and Isle of Wight (HIOW) region work to look after older people who have had a fall. The study will focus particularly on older people taking blood thinning medications who may have a head injury but do not have any symptoms. The investigators will ask NHS workers what their role is, where they work and what they do when assessing an older person who has fallen if there is a concern about head injury. The survey will also ask participants to describe what challenges they may face, and if they have any suggestions to improve the care for older people.
This study will help the investigators understand what services are available in our current healthcare system for older people on blood thinning medications who have fallen and may have a head injury. The investigators hope that the results will help improve how healthcare services can work together with older people and their closed ones to provide care based on what matters most to them in their preferred place of care. This could reduce unnecessary use of emergency services and hospital admissions for older people.
Read the detailed description
Falls is a common problem that impact older people (>65 years old). One in three people over the age of 65, and approximately half of those aged 80 and above experience a fall each year. Falls can have devastating consequences and lead to head injury, bone fractures, loss of confidences and death. Up to a third of older people who fall are taking anticoagulant and/or antiplatelet medications (blood thinners) for manage long-term conditions such as atrial fibrillation, ischaemic heart disease, and stroke. Due to concerns of bleeding in the brain after a fall, current national guidelines recommend that older people on anticoagulant or antiplatelet medications should be taken to hospital for assessment to consider whether CT head scan is needed. This is recommended even if patients do not have any signs of head injury, or worrying symptoms such as headache, weakness, or vomiting.
Performing a CT head on every older person on blood thinners who has fallen is not cost-effective nor practical. Current evidence suggests that the risk of bleeding in the brain is low (approximately 5%) in older people. Studies have reported that there is no increased risk of bleeding in the brain even if older people are on blood thinners, particularly if they do not have any worrying symptoms. However, many older people are often brought into hospital despite having no symptoms of head injury. This can lead to long waiting times to be seen in the Emergency Department.
For some older people, unnecessary hospital admissions can have a negative impact on their ability to walk, cause infections, confusions and pressure sores. The risk of being in hospital may not outweigh the small risk of having a brain bleed, particularly if they do not have any signs of head injury or worrying symptoms. Older people could have a comprehensive falls assessment, review of medications and follow-up outside of the hospital setting.
Alternative services to hospital admission for older people have been developed in the recent years to support people in their preferred place, and reduce pressures in the emergency departments. We know from clinical practice that services such as urgent community response teams, acute frailty wards, same day emergency care or hospital at homes often manage older people who have had a fall with possible head injury. Yet, no research studies have specifically reviewed care pathways and outcomes for older people on anticoagulant or antiplatelet medications who have had a fall and head injury with no symptoms outside the hospital.
We want to understand how the services in Hampshire and Isle of Wight region are working to support older people on anticoagulant and antiplatelet medications who have had a fall with head injury. We want to know what challenges healthcare workers experience, and what suggestions they have to improve this. This can help us improve service delivery for older people.
- Conditions
- Older Adults (65 Years and Older), Falls, Head Injury
- Keywords
- Older People, Anticoagulants, Antiplatelets, Falls, Head injury, Care pathways
- Medical subject headings
- Craniocerebral Trauma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| NHS Healthcare workers | NHS health professionals working in any sectors (primary, secondary, tertiary) within Hampshire and Isle of Wight that assess older people (age >65 who have had a fall as part of their job role |
What is being measured
The primary outcome is the main question the study is designed to answer.
Current healthcare service pathways
Describe healthcare services and clinical pathways across primary care, community care and secondary care services for older people following fall. This will include frequency and proportions of healthcare professionals' roles, experience, and assessment of an older person on anticoagulant or antiplatelet medications following a fall with asymptomatic head injury including availability of falls assessment and medication reviews.
Measured: 24 months
Secondary outcomes (1)
Challenges or barriers experienced by healthcare professionals
Understand experiences faced by healthcare professionals through qualitative analysis of open-ended questions
Measured: 24 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Aug 2025
- Study start11 Sep 2025
- Primary completion10 Nov 2025
- Study completion10 Nov 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Older Adults (65 Years and Older)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Retrospective
- Enrolment
- 1,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- Portsmouth Hospitals NHS Trust
- Sponsor type
- Other government
- Responsible party
- Sponsor
- Investigators
- Qian Yue Tan, PhD BM, Study chair, Portsmouth Hospitals NHS Trust
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07111871
- Sponsor's protocol ID
- PHU/2025/35
- Acronym
- Anti-HI-Falls
- Status last verified
- Sep 2026
- First submitted
- 14 Jul 2025
- Last updated
- 15 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: All data will be anonymised and will not be shared outside the research team.
Study at a glance
From the registry record, last updated by the sponsor on 15 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Understanding Care Pathways for Older People on Anticoagulant or Antiplatelet Medications With Falls and Head Injury
- ClinicalTrials.gov ID
- NCT07111871
- Acronym / sponsor ID
- Anti-HI-Falls / PHU/2025/35
- Conditions
- Older Adults (65 Years and Older), Falls, Head Injury
- Keywords
- Older People, Anticoagulants, Antiplatelets, Falls, Head injury, Care pathways
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 1,000 participants (actual)
- Lead sponsor
- Portsmouth Hospitals NHS TrustOther government
- Study start
- 11 Sep 2025 (actual)
- Primary completion
- 10 Nov 2025 (actual)
- Study completion
- 10 Nov 2025 (actual)
- First posted
- 8 Aug 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Every year, one in three older people (>65 years old) experience a fall. Older people may have long-term health conditions and take medications that can increase their risk of bleeding (blood thinners). The UK national guidelines recommend that older people who are on blood thinning medications should have a CT head scan considered due to concerns of a brain bleed if they have hit their head after a fall. Many older people are therefore brought into hospital for assessment. However, the risk of bleeding in the brain is very low especially if older people do not have any symptoms such as loss of consciousness, weakness, headaches or vomiting. Some people could experience long waits in the emergency department or end up being admitted to hospital unnecessarily. This could worsen mobility, cause confusion, pressure sores or infections in older people.
More importantly, older people should have a comprehensive falls assessment to reduce their risk of future falls and have their medications reviewed after experiencing a fall. These assessments could potentially take place in their own homes if they prefer, rather than in hospital. Yet, current healthcare services outside the hospital setting may not be set up to manage an older person after fall.
Using an online survey, the investigators want to understand how current healthcare services in the Hampshire and Isle of Wight (HIOW) region work to look after older people who have had a fall. The study will focus particularly on older people taking blood thinning medications who may have a head injury but do not have any symptoms. The investigators will ask NHS workers what their role is, where they work and what they do when assessing an older person who has fallen if there is a concern about head injury. The survey will also ask participants to describe what challenges they may face, and if they have any suggestions to improve the care for older people.
This study will help the investigators understand what services are available in our current healthcare system for older people on blood thinning medications who have fallen and may have a head injury. The investigators hope that the results will help improve how healthcare services can work together with older people and their closed ones to provide care based on what matters most to them in their preferred place of care. This could reduce unnecessary use of emergency services and hospital admissions for older people.
Detailed description
Falls is a common problem that impact older people (>65 years old). One in three people over the age of 65, and approximately half of those aged 80 and above experience a fall each year. Falls can have devastating consequences and lead to head injury, bone fractures, loss of confidences and death. Up to a third of older people who fall are taking anticoagulant and/or antiplatelet medications (blood thinners) for manage long-term conditions such as atrial fibrillation, ischaemic heart disease, and stroke. Due to concerns of bleeding in the brain after a fall, current national guidelines recommend that older people on anticoagulant or antiplatelet medications should be taken to hospital for assessment to consider whether CT head scan is needed. This is recommended even if patients do not have any signs of head injury, or worrying symptoms such as headache, weakness, or vomiting.
Performing a CT head on every older person on blood thinners who has fallen is not cost-effective nor practical. Current evidence suggests that the risk of bleeding in the brain is low (approximately 5%) in older people. Studies have reported that there is no increased risk of bleeding in the brain even if older people are on blood thinners, particularly if they do not have any worrying symptoms. However, many older people are often brought into hospital despite having no symptoms of head injury. This can lead to long waiting times to be seen in the Emergency Department.
For some older people, unnecessary hospital admissions can have a negative impact on their ability to walk, cause infections, confusions and pressure sores. The risk of being in hospital may not outweigh the small risk of having a brain bleed, particularly if they do not have any signs of head injury or worrying symptoms. Older people could have a comprehensive falls assessment, review of medications and follow-up outside of the hospital setting.
Alternative services to hospital admission for older people have been developed in the recent years to support people in their preferred place, and reduce pressures in the emergency departments. We know from clinical practice that services such as urgent community response teams, acute frailty wards, same day emergency care or hospital at homes often manage older people who have had a fall with possible head injury. Yet, no research studies have specifically reviewed care pathways and outcomes for older people on anticoagulant or antiplatelet medications who have had a fall and head injury with no symptoms outside the hospital.
We want to understand how the services in Hampshire and Isle of Wight region are working to support older people on anticoagulant and antiplatelet medications who have had a fall with head injury. We want to know what challenges healthcare workers experience, and what suggestions they have to improve this. This can help us improve service delivery for older people.
Study design
- Observational model
- Other
- Time perspective
- Retrospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| NHS Healthcare workers | – | –NHS health professionals working in any sectors (primary, secondary, tertiary) within Hampshire and Isle of Wight that assess older people (age >65 who have had a fall as part of their job role |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- This study is a cross-sectional mixed-methods online survey involving NHS healthcare professionals working in HIOW ICS across all relevant sectors. This could include those working in (but not limited to): * Acute hospitals including ED, Acute Medical Unit, Older Persons/Geriatric departments, Same Day Emergency Care services * Primary care services including out of hours * Community health services (urgent community response services, acute frailty wards, hospital at home, urgent treatment centres) * South Central Ambulance Services (SCAS) and 111 emergency services
Key inclusion criteria (4 listed)
- • Aged 18 years or above
Key exclusion criteria (1 listed)
- • Did not consent to participate on the completed survey
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Current healthcare service pathways
Time frame: 24 months
Describe healthcare services and clinical pathways across primary care, community care and secondary care services for older people following fall. This will include frequency and proportions of healthcare professionals' roles, experience, and assessment of an older person on anticoagulant or antiplatelet medications following a fall with asymptomatic head injury including availability of falls assessment and medication reviews.
1 secondary outcome
Challenges or barriers experienced by healthcare professionals
Time frame: 24 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Sep 2026.
- Individual participant dataSharing planned: No. All data will be anonymised and will not be shared outside the research team.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Qian Yue Tan, PhD BM study chair
Portsmouth Hospitals NHS Trust
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Older Adults (65 Years and Older) and Falls, run by Portsmouth Hospitals NHS Trust at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Current healthcare service pathways (time frame: 24 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2026; AzTrials last refreshed its copy on 26 Oct 2026.