Gender differences in treatment outcomes for alcohol dependence among older adults.

Satre, Derek D.; Mertens, Jennifer R.; Weisner, Constance

doi:10.15288/jsa.2004.65.638

Cited by 43 publications

(30 citation statements)

References 21 publications

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“…Patients who did not agree to be randomized but agreed to other aspects of the study were consented, followed, and included in the analyses. These datasets were combined and analyzed together as has been done previously in other studies (Chi et al, 2011; Satre et al, 2007; Satre et al, 2004; Tsoh et al, 2011; Weisner et al, 2010a; Weisner et al, 2010b). Variables indicating study sample and randomization status were added to all models to control for potential study effects.…”

Section: Methodsmentioning

confidence: 99%

Five-Year Healthcare Utilization and Costs Among Lower-Risk Drinkers Following Alcohol Treatment

Kline-Simon

Weisner

Parthasarathy

et al. 2013

Alcohol Clin Exp Res

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Introduction Lower-risk drinking is increasingly being examined as a treatment outcome for some patients following addiction treatment. However, few studies have examined the relationship between drinking status (lower-risk drinking in particular) and health care utilization and cost which has important policy implications. Methods Participants were adults with alcohol dependence and/or abuse diagnoses who received outpatient alcohol and other drug treatment in a private, non-profit integrated health care delivery system and had a follow-up interview 6-months after treatment entry (N=995). Associations between past 30-day drinking status at 6 months (abstinence, lower-risk drinking defined as non-abstinence and no days of 5+ drinking, and heavy drinking defined as one or more days of 5+ drinking) and repeated measures of at least one emergency department (ED), inpatient or primary care visit and their costs over 5 years were examined using mixed effects models. We modeled an interaction between time and drinking status to examine trends in utilization and costs over time by drinking group. Results Heavy drinkers and lower-risk drinkers were not significantly different from the abstainers in their cost or utilization at time 0 (i.e. 6 months post intake). Heavy drinkers had increasing odds of inpatient (p<.01) and ED (p<.05) utilization over 5 years compared to abstainers. Lower-risk drinkers and abstainers did not significantly differ in their service use in any category over time. No differences were found in changes in primary care use among the three groups over time. The cost analyses paralleled the utilization results. Heavy drinkers had increasing ED (p<.05) and inpatient (p<.001) costs compared to the abstainers; primary care costs did not significantly differ. Lower-risk drinkers did not have significantly different medical costs compared to those who were abstinent over 5 years. However, post-hoc analyses found lower-risk drinkers and heavy drinkers to not significantly differ in their ED use or costs over time. Conclusion Performance measures for treatment settings that consider treatment outcomes may need to take into account both abstinence and reduction to non-heavy drinking. Future research should examine whether results are replicated in harm reduction treatment, or whether such outcomes are found only in abstinence-based treatment.

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Section: Methodsmentioning

confidence: 99%

Five-Year Healthcare Utilization and Costs Among Lower-Risk Drinkers Following Alcohol Treatment

Kline-Simon

Weisner

Parthasarathy

et al. 2013

Alcohol Clin Exp Res

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“…23 Older women have higher abstinence rates than older men following chemical dependency treatment, based on a study of 92 alcohol dependent patients ages 55 and over in a managed-care outpatient treatment program. 24 In that study, women had a later onset of heavy drinking than men had, but were drinking similar amounts of alcohol at the time of treatment entry. In a Canadian population-based survey of older adults, women were more likely than men to take steps to improve their health such as changing diet and using preventive services.…”

mentioning

confidence: 87%

Alcohol Consumption, Medical Conditions, and Health Behavior in Older Adults

Satre¹,

Gordon²,

Weisner³

2007

am j health behav

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Objectives-To examine associations between drinking patterns, medical conditions, and behavioral health risks among older adults.Methods-Analyses compared survey participants (health plan members ages 65 to 90, N = 6662) who drank moderately to those who drank over recommended limits or did not drink.Results-Overlimit drinking was associated with smoking; not trying to eat low-fat foods (in men), and lower BMI (in women). Predictors of not drinking during the prior 12 months included ethnicity, lower education, worse self-reported health, diabetes and heart problems.Conclusions-Significant relationships exist between health and alcohol consumption patterns, which vary by gender.Keywords older adults; alcohol; behavioral health risks; obesity; gender; ethnicity Older adults compose a large and fast-growing segment of the US population. Yet alcohol consumption in this demographic group has received little study. This is a significant oversight because heavy drinking has been associated with development of multiple medical, 1,2 functional, 3 and psychiatric problems to which older adults are especially vulnerable. 4,5 Excessive alcohol consumption may be clustered with other behavioral health risks such as smoking and poor diet 6,7 and obesity, 8 increasing cumulative risk for medical problems. In contrast, light to moderate drinking may have health benefits. 9 In studies of heart disease, moderate drinking has been associated with lower mortality than either abstinence or heavy consumption. [10][11][12] These studies indicate that alcohol is harmful to health in excess but potentially helpful in moderation and that the relationship of drinking to health is complex.To prevent serious health problems, recommended drinking limits for older adults have been proposed. 7,13 Because alcohol can exacerbate medical conditions and has potential for adverse medication interactions, older adults with health problems who drank when they were younger may stop drinking completely. [14][15][16] This tendency may explain why studies comparing older adults who drink heavily or moderately to those who abstain completely Address correspondence to Dr Satre, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, Box 0984, San Francisco, CA 94143. dereks@lppi.ucsf.edu. NIH Public Access Author ManuscriptAm J Health Behav. Author manuscript; available in PMC 2013 May 20.Published in final edited form as: Am J Health Behav. 2007 ; 31(3): 238-248. doi:10.5555/ajhb.2007.31.3.238. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript have found that abstainers have poorer health. [17][18][19] For example, in a large sample of male primary care patients ages 65 and over, patients who reported drinking alcohol in the previous year had better health status (as measured by the SF-36) than did abstainers. 17 Epidemiological studies have found that older women tend to drink smaller quantities of alcohol than older men do, have fewer alcohol-related problems, 20,21 and are more likel...

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“…; Hser et al. , ; Satre, Mertens, and Weisner ), with little attention to differences between these two groups and Latinos, the fastest growing population in SAT (Morgenstern and Bux ; Marsh et al. ; Guerrero et al.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Disparities in Completion of Substance Abuse Treatment between and within Racial and Ethnic Groups

Guerrero

Marsh

Duan

et al. 2013

Health Services Research

143

112

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Objective. To evaluate disparities in substance abuse treatment completion between and within racial and ethnic groups in publicly funded treatment in Los Angeles County, California. Data Source. The Los Angeles County Participant Reporting System with multicross-sectional annual data (2006)(2007)(2008)(2009) for adult participants (n = 16,637) who received treatment from publicly funded programs (n = 276) for the first time. Study Design. Retrospective analyses of county discharge and admission data. Hierarchical linear regressions models were used to test the hypotheses. Data Collection. Client data were collected during personal interviews at admission and discharge for most participants. Principal Findings. African Americans and Latinos reported lower odds of completing treatment compared with Whites. Within-group analysis revealed significant heterogeneity within racial and ethnic groups, highlighting primary drug problem, days of drug use before admission, and homelessness as significant factors affecting treatment completion. Service factors, such as referral by the criminal justice system, enabled completion among Latinos and Whites only. Conclusions. These findings have implications for reducing health disparities among members of racial and ethnic minorities by identifying individual and service factors associated with treatment adherence, particularly for first-time clients.

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Gender differences in treatment outcomes for alcohol dependence among older adults.

Cited by 43 publications

References 21 publications

Five-Year Healthcare Utilization and Costs Among Lower-Risk Drinkers Following Alcohol Treatment

Five-Year Healthcare Utilization and Costs Among Lower-Risk Drinkers Following Alcohol Treatment

Alcohol Consumption, Medical Conditions, and Health Behavior in Older Adults

Disparities in Completion of Substance Abuse Treatment between and within Racial and Ethnic Groups

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