An electronic health record tool for exercise prescription may reduce fall rate among older adults

1. In a large randomized clinical trial among 22 primary care practices, use of an electronic health record-integrated clinical decision support tool known as Electronic Strategies for Tailored Exercise to Prevent Falls (eSTEPS) significantly reduced the fall rate among older adults when in comparison to the control.

Evidence Rating Level: 1 (Excellent)

Falls among older adults are a major cause of injury, disability, and increased mortality among older adults, yet practical and evidence-based exercise regimens are not implemented among primary care practices at a consistent rate. This study compared the use of a digital electronic health record tool known as Strategies for Tailored Exercise to Prevent Falls (eSTEPS) among primary care patients to a control group of patients who did not receive a regimented exercise program. These patients were aged 65 or older and were followed for 12-23 months following implementation of the exercise program, which consisted of tailored exercise recommendations, optional physical therapy referral, and patient-facing materials such as a handbook, website, or various apps. Among the 11945 participants, 52.4% were in the control group and 47.6% were in the intervention group. The rate of ICD-10-coded falls among patients in the control group was 21.2 (95% CI, 20.2-22.1) and the rate among the intervention group was 19.3 (95% CI, 18.6-20.1) within the study period. No differences were observed in mortality. Overall, the study findings suggest that implementation of an evidence-based, accessible, and regimented exercise prescription at the primary care level significantly decreased the risk of falls among older patients aged 65 and above.

Click here to read this study in JAMA Network Open

Citation: Latham NK, Hommel E, Kiesman M, Lipsitz SR, Bates DW, Carroll DL, et al. Clinical Decision Support for Fall Prevention in Primary Care: The eSTEPS Cluster Randomized Clinical Trial. JAMA Netw Open. 2026 Oct 1;9(10):e2639240. doi: 10.1001/jamanetworkopen.2026.39240. PMID: 42886484; PMCID: PMC13675817.

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