Oncology · Medical Literature
A clinical study on fall risk assessment and preventive nursing in older adults with non-Hodgkin's lymphoma undergoing chemotherapy-a randomized controlled trial.
Abstract
Non-Hodgkin's lymphoma (NHL) is a diverse group of lymphoproliferative malignancies that predominantly affects older adults. Chemotherapy remains the primary modality of treatment for many NHL subtypes, yet it often brings about adverse effects such as myelosuppression, anemia, and neuropathy, all of which contribute to a heightened risk of falls in older patients. Falls in this population can lead to serious complications, including fractures and intracranial injuries, thereby impacting functional status and potentially delaying oncological treatment. This study was aimed at assessing the efficacy of a structured, evidence-based preventive nursing protocol in reducing falls among older patients with NHL undergoing chemotherapy compared to standard care. A prospective, single-center randomized controlled trial enrolled 210 older patients (≥ 65 years) newly diagnosed with or relapsed NHL requiring chemotherapy. Participants were randomly assigned to an Intervention Group-receiving a multifaceted preventive nursing program based on individualized risk assessment-or a Control Group that received standard oncology nursing. Primary outcomes included fall incidence and recurrence. Secondary outcomes encompassed fall-related injuries, Timed Up and Go (TUG) test performance, chemotherapy completion, and quality of life. Statistical analyses were conducted using SPSS 27.0 with significance set at p < 0.05. Of 210 participants enrolled, 194 (98 in the Intervention Group and 96 in the Control Group) completed the 12-week follow-up. The Intervention Group demonstrated a significantly lower fall incidence (7.1%) compared with the Control Group (19.8%, p = 0.012). Patients in the Intervention Group had fewer severe injuries, better chemotherapy adherence, improved functional mobility as measured by TUG tests, and higher quality of life scores. A targeted, multifactorial nursing intervention substantially reduced falls and fall-related complications among older adults with NHL receiving chemotherapy. Integration of fall prevention measures into routine oncologic care is strongly recommended to safeguard treatment continuity and patient well-being. Further multicenter and long-term studies are warranted to validate these findings and refine comprehensive fall prevention strategies.
Clinical relevance
Does a structured, individualized, evidence-based preventive nursing protocol reduce fall incidence and recurrence in older adults (≥65 years) with Non-Hodgkin's lymphoma undergoing chemotherapy compared with standard oncology nursing care? __SNAPSHOT__ {"studyDesign":"Prospective, single-center randomized controlled trial","setting":"Single center; country not specified in the abstract","sampleSize":"n=210 (intervention: not reported; control: not reported; allocation ratio not specified in abstract)","population":"Adults aged ≥65 years with newly diagnosed or relapsed Non-Hodgkin's lymphoma requiring chemotherapy","intervention":"Multifaceted preventive nursing program based on individualized fall-risk assessment (specific components — e.g., exercise, environmental modification, patient education, medication review — not detailed in the abstract)","comparator":"Standard oncology nursing care","primaryOutcome":"Fall incidence and fall recurrence (abstract text is truncated; additional primary or co-primary endpoints may exist but are not reported)","followUp":"Not reported in the available abstract","fundingSource":"Not reported"}
Key findings
The abstract is truncated at the point of results reporting; therefore, no quantitative primary outcome data — including absolute fall rates, relative risk or risk ratio, odds ratio, hazard ratio, confidence intervals, p-values, or NNT/NNH — are available for summary. No secondary outcome results (e.g., injury severity, functional status, chemotherapy completion rates, quality of life) or safety/adverse event data are presented in the available text. All numerical effect estimates are absent and cannot be reported without access to the full publication.
Practice implications
Based solely on the available truncated abstract, it is not possible to determine whether the intervention significantly reduced fall incidence or recurrence, the magnitude of any observed effect, the clinical importance of the findings, or whether results are generalizable to other oncology settings or NHL subtypes. The rationale for the intervention is well-grounded: chemotherapy-associated myelosuppression, anemia, and peripheral neuropathy are established contributors to elevated fall risk in older patients with hematologic malignancies, and falls in this context can cause fractures, intracranial injury, functional decline, and treatment delays. However, the efficacy, safety, and operational feasibility of the specific nursing protocol described in this trial cannot be assessed from the abstract alone. Clinicians should seek the full publication before drawing conclusions. The study is single-center, which limits external validity. Older adults with NHL receiving certain regimens (e.g., vincristine-containing) may represent a particularly high-risk subgroup, but subgroup-level findings are not available. Note: this summary is based on abstract-only access; the full article may report additional outcomes, statistical analyses, and contextual data not captured here. __LIMITATIONS__ Only a truncated abstract is available; results, statistical analyses, secondary outcomes, and adverse events cannot be evaluated.,Single-center design limits generalizability across different healthcare systems, institutions, and geographic regions.,Allocation ratio between intervention and control arms is not specified, precluding assessment of balance.,Duration of follow-up is not reported, making it impossible to assess sustainability of any fall-prevention effect beyond the chemotherapy treatment period.,Blinding: participant blinding to a behavioral/nursing intervention is inherently difficult; assessor blinding status is not described.,Specific components of the multifaceted nursing protocol are not described in the abstract, precluding replication or comparative assessment.,Potential for selection bias and performance bias in open-label nursing intervention trials.,NHL is a heterogeneous malignancy; chemotherapy regimens differ substantially across subtypes, and the distribution of regimens — particularly those with high neurotoxic potential — is not reported.,Funding source is not reported; potential conflicts of interest cannot be assessed.,No sample size calculation or power analysis is mentioned in the abstract. __BOTTOM_LINE_CATEGORY__ low_certainty __BOTTOM_LINE__ This single-center RCT examined whether an individualized preventive nursing program reduces falls in older adults with NHL undergoing chemotherapy; however, the abstract is truncated and no quantitative results are available for clinical interpretation. The mechanistic rationale is sound given the known fall risk from chemotherapy-associated neuropathy, anemia, and myelosuppression in this population. Clinicians should review the full publication before considering adoption of the described protocol into practice.