The Effect of an Educational Intervention on Alcohol Consumption, At-Risk Drinking, and Health Care Utilization in Older Adults: The Project SHARE Study

Ettner, Susan L.; Xu, Hongquan; Duru, O. Kenrik; Ang, Alfonso; Tseng, Chi‐Hong; Tallen, Louise; Barnes, Andrew J.; Mirkin, Michelle; Ransohoff, Kurt; Moore, Alison

doi:10.15288/jsad.2014.75.447

Cited by 54 publications

(109 citation statements)

References 22 publications

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“…Participants were recruited from three health care organizations located in Southern California. Participants aged 55 and older were identified as at-risk drinkers using the Co-morbidity Alcohol Risk Evaluation Tool (CARET) [23–24]. The CARET is a measure to identify at-risk drinking older adults.…”

Section: Methodsmentioning

confidence: 99%

“…Prior studies have shown that brief behavioral counseling interventions provided by primary care physicians have reduced alcohol misuse in adults [19, 20] and that these interventions were also effective for the older adult population [21–24]. In addition, alcohol screening and counseling in primary care has been shown to be both cost effective from the health system perspective and cost saving from the societal perspective [25].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Older At-Risk Drinkers Who Drive After Drinking and Those Who Do Not Drive After Drinking

Sanna¹,

Tuqan

Goldsmith³

et al. 2014

Traffic Injury Prevention

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Objective To describe and compare characteristics of older adults who drive after drinking and those who do not, whether an intervention addressing at-risk drinking reduces risk among those reporting driving after drinking, and reasons reported for driving after drinking. Methods Secondary data analysis of a randomized trial testing the efficacy of a multifaceted intervention to reduce at-risk drinking among adults with a mean age of 68 years in primary care (N=631). Results Almost a quarter of at-risk drinkers reported driving after drinking (N=154). Compared to those who did not drive after drinking, those who did were more likely to be younger, male and working. They consumed a higher average number of drinks per week, had more reasons they were considered at-risk drinkers, and were more likely to meet at-risk drinking criteria due to amount of drinking and binge drinking. Those driving after drinking at baseline reduced the frequency of this behavior at 3- and 12-months and there were no statistically significant differences in the proportions of persons still engaging in driving after drinking among those who were assigned to intervention or control groups. Reasons for driving after drinking included not thinking it was a problem and having to get home. Conclusions Driving after drinking is common in this population of older, at-risk drinkers recruited in primary care settings, and, like younger adults, men and those reporting binge drinking are more likely to engage in this behavior. Given this behavior is dangerous and the population of older adults is fast growing, interventions addressing driving after drinking are needed.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics of Older At-Risk Drinkers Who Drive After Drinking and Those Who Do Not Drive After Drinking

Sanna¹,

Tuqan

Goldsmith³

et al. 2014

Traffic Injury Prevention

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show abstract

“…Unlike PRISM-E, which compared integrated and enhanced referral care—neither of which were usual care, these RCTs compared various intervention models with usual care (44–47). In all trials, there were significantly higher reductions in alcohol misuse for integrated care compared to usual care.…”

Section: Discussionmentioning

confidence: 99%

Comparing behavioral health models for reducing risky drinking among older male veterans

Wooten

Tavakoli

Al-Barwani

et al. 2017

The American Journal of Drug and Alcohol Abuse

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Background Screening older veterans in Veterans Affairs Medical Center (VAMC) primary care clinics for risky drinking facilitates early identification and referral to treatment. Objective This study compared two behavioral health models, integrated care (a standardized brief alcohol intervention co-located in primary care clinics) and enhanced referral care (referral to specialty mental health or substance abuse clinics), for reducing risky drinking among older male VAMC primary care patients. VAMC variation was also examined. Method A secondary analysis of longitudinal data from the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study, a multisite randomized controlled trial, was conducted with a sample of older male veterans (n = 438) who screened positive for risky drinking and were randomly assigned to integrated or enhanced referral care at five VAMCs. Results Generalized estimating equations revealed no differences in either behavioral health model for reducing risky drinking at a 6-month follow-up (AOR: 1.46; 95% CI: 0.42–5.07). Older veterans seen at a VAMC providing geriatric primary care and geriatric evaluation and management teams had lower odds of risky drinking (AOR: 0.24; 95% CI: 0.07–0.81) than those seen at a VAMC without geriatric primary care services. Conclusions Both integrated and enhanced referral care reduced risky drinking among older male veterans. However, VAMCs providing integrated behavioral health and geriatric specialty care may be more effective in reducing risky drinking than those without these services. Integrating behavioral health into geriatric primary care may be an effective public health approach for reducing risky drinking among older veterans.

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“…Disappointingly, only two RCTs (Moore et al, 2010;Ettner et al, 2014) found a statistically significant advantage of intervention over CAU. However, in all but one trial, the outcome variable (number of drinks, number of patients drinking at-risk, and score on AUDIT) decreased significantly in both intervention and CAU groups.…”

Section: Treatment Of Alcohol Use Disorders In the Elderly: An Overvimentioning

confidence: 96%

“…One study (Oslin, 2005), identified by Moy et al (2011), was not included in the review by Kuerbis et al (2013). With an additional literature search for the preparation of this editorial, two RCTs were found that have been published very recently (Ettner et al, 2014;Vrdoljak et al, 2014). Thus, at least 15 RCTs are published on the treatment of AUD (see reference lists of all RCTs).…”

Section: Treatment Of Alcohol Use Disorders In the Elderly: An Overvimentioning

confidence: 99%

Treatment of alcohol use disorders in the elderly: an overview of RCTs

Kok¹

2014

Int. Psychogeriatr.

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In this issue of International Psychogeriatrics, our research group published a paper on alcohol use disorders (AUD) in elderly adults (Kist et al., 2014). According to different authors, age of onset is an important characteristic to distinguish subgroups of patients with AUD, similar to, for example, late-onset depression (LOD) and late-onset schizophrenia (LOS). The cut off age to discriminate between early and late-onset AUD varies but is often 25 years, which is substantially younger than the cutoffs to discriminate LOD or LOS. However, in AUD, many patients started having alcohol problems much later in life, for example, after 45, 50, or even after 60 years. These very late onset patients are almost completely ignored in research. In a group of older inpatients with AUD, we found that those who started drinking heavily after 25 and after 45 years of age have similar cognitive impairments compared with their peers who started drinking before 25 years of age. Our results are counter-intuitive at first instance, but some other authors have found the same results. However, several potential limitations may also account for this result, and replication is needed before conclusions that are more definite can be drawn. In the preparation of this editorial, we found a lack of research in patients who started drinking excessive amounts of alcohol very late in life. This is in contrast with, for example, a fair amount of research in LOD and at least some research in LOS.

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The Effect of an Educational Intervention on Alcohol Consumption, At-Risk Drinking, and Health Care Utilization in Older Adults: The Project SHARE Study

Cited by 54 publications

References 22 publications

Characteristics of Older At-Risk Drinkers Who Drive After Drinking and Those Who Do Not Drive After Drinking

Characteristics of Older At-Risk Drinkers Who Drive After Drinking and Those Who Do Not Drive After Drinking

Comparing behavioral health models for reducing risky drinking among older male veterans

Treatment of alcohol use disorders in the elderly: an overview of RCTs

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