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To determine if there was an improvement in nurses' communication skills 5 months after a multiple component intervention to implement the Registered Nurses Associationn of Ontario best practice guideline 'Establishing Therapeutic Relationships'.
Another study [ 36] combined results from single and multiple component interventions and it was not possible to extract the data for the multiple component intervention in relation to falls or fractures.
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They concluded that few multiple component interventions were effective.
Three studies [ 20, 31, 32] had two or more intervention arms that each comprised multiple component interventions and were separately compared with the control arm.
Five of the seven studies of multiple component interventions reported significant improvements in the rates of generic prescribing associated with the intervention.
Gillespie et al. [ 4] reported the findings from 19 RCTs examining multiple component interventions, although studies were not pooled due to clinical heterogeneity of the interventions.
Random effects meta-analysis was used to pool estimates of the effects of multiple component interventions using the DerSimonian-Laird method [ 17].
International research also indicates that multiple component interventions may assist in supporting caregivers of people with dementia living in the community [ 31] and that multimodal interventions are associated with decreases in caregiver burden [ 32](M).
The study objective was to determine the effect of multiple component interventions on fall rates, number of fallers and fall-related injuries among older people and to establish effect sizes of particular intervention combinations.
Whilst Gillespie and colleagues included multiple component interventions as part of their review, their synthesis was narrative with each study reported separately due to the variety of combined interventions undertaken [ 4].
We assessed RCTs that compared multiple component interventions, where participants received a fixed combination of two or more interventions that were not individually tailored based on a fall risk assessment, with a control.
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