Comparison of Consumption Effects of Brief Interventions for Hazardous Drinking Elderly

Abstract

We sought to determine if Brief Interventions [BIs, Motivational Enhancement (ME), and Brief Advice (BA)] reduced alcohol consumption among hazardous alcohol drinking elderly (65 years or older) and whether the elderly responded similarly to younger populations. In 12 primary care offices from 10 1995 to 12 1997, we screened 13,438 patients of whom 2702 were elderly (180 were hazardous drinkers). Forty-five elderly enrollees were randomized to receive ME (n = 18), BA (n = 12), and Standard Care (SC, n = 12). At baseline, the elderly drank more alcohol and abstained fewer days than the younger cohort (p<0.05). During the year, the elderly in ME, BA, and SC intervention arms increased the number of days abstained, decreased the number of drinks per day, and reduced the number of total days per month drinking. There were trends toward decreases in the alcohol consumption measures in the ME and BA treatment arms compared to SC. The elderly's response to all interventions was similar to that of the younger cohort. This study suggests that hazardous alcohol consumption in the elderly is common and that BIs reduce alcohol consumption in the elderly similar to younger populations.

• Alcohol drinking
• Counseling
• Aged
• Randomized controlled trial
• Early interventions
• Hazardous drinking

Resumen

Intentamos determinar si mediante breves intervenciones (BI), terapia de motivación para mejorar (ME), y breves asesorias (BA) se logra reducir el consumo inmoderado de alcohol en grupos de personas de 65 años o mayores, y si dicho grupo respondía de manera similar a la población de personas más jóvenes. De octubre de 1995 a diciembre de 1997, en doce oficinas de asistencia medica primaria, examinamos a 13.438 pacientes de quienes 2.702 eran mayores (180 bebían en cantidades peligrosas). Se seleccionaron al azar a cuarenticinco ancianos para recibir ME (n=18), BA (n=12), y Asistencia Ordinaria (AE AO, n=12). Al principio, los arieranos bebían más alcohol y se abstenían un numero más pequeño de días que el grupo de personas más jovenes (p<0.05). En el transcurso del año, se hizo evidente que en los ancianos que recibieron ME, BA, y AO, aumento el número de días de abstinencia, disminuyó el número de bebidas consumidas por día, y se redujo el número total de días por mes en que bebían. En los pacientes que recibieron tratamientos ME y BA se mostraron tendencias hacia un menor consumo de alcohol en comparación con el grupo AO. El grupo de personas mayores respondió en todas las intervenciones de manera semejante al grupo de gente más joven. Este estudio sugiere que el consumo inmoderado y peligroso del alcohol es común entre las personas mayores y que

Résumé

Nous avons cherché à déterminer si les programmes d'Interventions Courtes (IC), D'Accroissement de Motivation (AM), et de Bref Conseils (BC), réduiraient la consommation d'alcool auprès des personnes âgées (de plus de 65 ans) considérees comme consommateurs abusifs d'alcool et si ces personnes réagiraient de la même manière que la population de moins de 65 ans. Dans le cadre de notre étude au sein de 12 cabinets médicaux que nous avons effectuée d'Octobre 1995 à Décembre 1997, répétoriant 13,438 patients, 2,702 étaient âgés et parmi eux 180 étaient consommateurs abusifs d'alcool. Quarante cinq des personnes inscrites furent réparties de facon non-pré-déterminée entre les programmes AM (n=18), BC (n=12), et les Soins Médicaux Habituels (SMH, n=12). Par rapport à la population plus jeune, la population de plus de 65 ans avait tendance à boire en grande quantité au début, puis à s'abstenir quelque jours (p<.05). Au cours d'une année d'étude, les participants des trois programmes (AM, BC et SMH) ont augmenté le nombre de jours d'abstinence, diminué la quantitée d'alcool bue et réduit le nombre de jours de consommation mensuel. Concernant les programmes BC et AM, les participants ont eu tendance à diminuer leur consommation d'alcool (en quantitée) par rapport au groupe du programme SMH. Les personnes de plus et moins de 65 ans ont reagit de la même manière aux programmes. Cette enquête nous suggére que la consommation d'alcool de facon abusive parmi les personnes âgées est courante et les programmes d'intervention (IC) aident les personnes âgées autant que les personnes plus jeunes.

Additional information

Notes on contributors

Adam J. Gordon

Adam J. Gordon, M.D., M.P.H., is Assistant Professor of Medicine at the University of Pittsburgh and a staff physician at the VA Pittsburgh Healthcare System. He is a core member of the VA Center for Health Equity Research and Promotion, University of Pittsburgh's Center for Research on Health Care, and the Mental Illness Research Education and Clinical Center of VISN4. His research and clinical interests include screening and treatment of alcohol and other drug disorders, homeless health care delivery, and the medical, psychiatric, and social care of HIV+ persons.

Joseph Conigliaro

Joseph Conigliaro, M.D., M.P.H., is Associate Professor of Medicine and Epidemiology at the University of Pittsburgh and a staff physician at the VA Pittsburgh Healthcare System. He is a core member of the VA Center for Health Equity Research and Promotion, University of Pittsburgh's Center for Research on Health Care, and the Mental Illness Research Education and Clinical Center of VISN4. His research and clinical interests include screening and treatment of alcohol abuse in general medical Ésettings and health care variation of vulnerable populations.

Stephen A. Maisto

Stephen A. Maisto, Ph.D., A.B.P.P., is a clinical psychologist who is Professor of Psychology at Syracuse University. He also is a core faculty member of the Department of Psychology's Center for Health and Behavior. His research interests include the assessment and treatment of substance use disorders, the determinants of alcohol and other drug use, and HIV prevention.

Melissa McNeil

Melissa McNeil, M.D., M.P.H., is Professor of Medicine at the University of Pittsburgh and Chief, Section of Women's Health, Division of General Internal Medicine. She has a longstanding interest in substance abuse and was instrumental in developing the Substance Abuse Detection and Early Intervention Program at the VA Pittsburgh Healthcare System. Her clinical and research interests include brief interventions in the area of substance abuse, drinking and pregnancy, and domestic violence.

Kevin L. Kraemer

Kevin L. Kraemer, M.D., M.Sc., is Assistant Professor of Medicine and Health Services Administration at the University of Pittsburgh School of Medicine and Graduate School of Public Health. His research program focuses on alcohol/drug screening and intervention in various clinical settings and the application of cost-effectiveness and cost-utility analysis to these problems.

Mary E. Kelley

Mary E. Kelley, M.S., is a biostatistician for the VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, and the Mental Illness Research Education and Clinical Center of VISN4. Her primary research interests include mental health disorders, specifically schizophrenia.