Harm reduction among at-risk elderly drinkers: A site-specific analysis from the multi-site Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study

Heather Sophia Lee, Amy A. Mericle, Liat Ayalon, Patricia A. Areán

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Objectives: To assess the efficacy of a harm-reduction based intervention to enhance access to treatment and clinical outcomes among elderly at-risk drinkers. Design: A site-specific secondary data analysis of Primary Care Research in Substance Abuse and Mental Health for Elders study (PRISM-E). Participants: Thirty-four at-risk drinkers age 65 or older who were randomized into one of two treatment conditions: an integrated care condition which incorporated a harm-reduction based approach to treatment and an enhanced referral condition. Measures: Access to subsequent services and clinical outcomes were examined 6 months post index-interview date. Clinical outcomes included changes in the number of drinks in the week prior to assessment, changes in the number of binges in the past 3 months prior to assessment, and changes in scores on the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G). Results: At-risk drinkers in the integrated care condition were more likely to access treatment than at-risk drinkers assigned to the enhanced referral condition (93% vs 35%; χ2=11.38, df=1, p=0.001). Among those who received treatment, there were no differences in the total amount of treatment visits or in the number of brief alcohol interventions received among at-risk drinkers in the two conditions. However, those in integrated care condition received services sooner than those in the referral condition. Those in the integrated care condition showed a significant decrease in the number of drinks in the past week and in the number of binge drinking episodes in the past 3 months while there were no significant changes in these outcomes among the at-risk drinkers in the enhanced referral condition. Conclusions: At-risk drinkers in the integrated care condition were more likely to access treatment and decrease harmful drinking behaviors than those in the enhanced referral condition. Implications for future research and treatment are discussed.

Original languageEnglish (US)
Pages (from-to)54-60
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Volume24
Issue number1
DOIs
StatePublished - 2009
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Keywords

  • Access to care
  • Geriatrics
  • Harm-reduction
  • Mental health services
  • Older adults
  • Substance abuse services

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