Alcohol use in the elderly is an increasingly important public health problem. Traditional interventions focus on abuse and dependence in younger persons. Alcohol-related risks and problems in older persons, however, may come from the interaction between alcohol and diminished health or medication use. The proposed study is a randomized trial of the effectiveness and cost-effectiveness of an integrated patient provider intervention to prevent harmful (presence of alcohol-related problems such as liver disease or depression) and hazardous alcohol use (risks for problems) in older adults. The intervention will include a tested computerized screening and education system that was developed especially for older adults and their providers, supplemented by a well-established intervention for physicians. The patient component uses the Computerized Alcohol-Related Problems Survey, which results in printed Patient and Physician Reports with classification of the patient as a harmful, hazardous or non-hazardous drinker and reasons for the classification. The Patient Report references a companion educational booklet developed for older adults. The provider component is based on a physician intervention with proven effectiveness. The proposed research design involves randomization of 28 primary care physicians in four clinics and their eligible patients aged 65+ to the intervention vs. """"""""usual care."""""""" Specific aims are to (1) evaluate the comparative effectiveness of a patient and physician educational intervention to prevent harmful and hazardous alcohol use in the elderly, relative to usual care; (2) evaluate the comparative costs of the intervention, relative to usual care; and (3) evaluate the post-effectiveness of the intervention, relative to usual care. Effectiveness measures include whether patients engage in hazardous and harmful drinking and their health-related quality of life; proximal outcomes examined include knowledge and self-efficacy. The cost-effectiveness analysis of Aim 3 will performed only if the Aim 2 analyses show that the intervention group has higher net costs than the control arm; if the intervention is cost-saving with equally good outcomes, or cost-neutral with better outcomes, then the intervention is cost-effective by definition.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA013990-04
Application #
7229043
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Lowman, Cherry
Project Start
2004-08-01
Project End
2010-04-30
Budget Start
2007-05-01
Budget End
2010-04-30
Support Year
4
Fiscal Year
2007
Total Cost
$530,235
Indirect Cost
Name
University of California Los Angeles
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Barnes, Andrew J; Xu, Haiyong; Tseng, Chi-Hong et al. (2016) The Effect of a Patient-Provider Educational Intervention to Reduce At-Risk Drinking on Changes in Health and Health-Related Quality of Life Among Older Adults: The Project SHARE Study. J Subst Abuse Treat 60:14-20
Duru, Obidiugwu K; Xu, Haiyong; Moore, Alison A et al. (2015) Examining the Impact of Separate Components of a Multicomponent Intervention Designed to Reduce At-Risk Drinking Among Older Adults: The Project SHARE Study. Alcohol Clin Exp Res 39:1227-35
Ettner, Susan L; Xu, Haiyong; Duru, O Kenrik et al. (2014) The effect of an educational intervention on alcohol consumption, at-risk drinking, and health care utilization in older adults: the Project SHARE study. J Stud Alcohol Drugs 75:447-57
Yan, Tingjian; Xu, Haiyong; Ettner, Susan L et al. (2014) At-risk drinking and outpatient healthcare expenditures in older adults. J Am Geriatr Soc 62:325-8
Barnes, Andrew J; Moore, Alison A; Xu, Haiyong et al. (2010) Prevalence and correlates of at-risk drinking among older adults: the project SHARE study. J Gen Intern Med 25:840-6
Duru, O Kenrik; Xu, Haiyong; Tseng, Chi-Hong et al. (2010) Correlates of alcohol-related discussions between older adults and their physicians. J Am Geriatr Soc 58:2369-74
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Moore, Alison A; Whiteman, Elizabeth J; Ward, Katherine T (2007) Risks of combined alcohol/medication use in older adults. Am J Geriatr Pharmacother 5:64-74