The effect of an educational intervention on alcohol consumption, at-risk drinking, and health care utilization in older adults: the Project SHARE study

Affiliations

¹ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Department of Health Policy and Management, School of Public Health, University of California at Los Angeles, Los Angeles, California.
² Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
³ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Ahava Center for Spiritual Living, Lexington, Kentucky (current affiliation).
⁴ Department of Health Policy and Management, School of Public Health, University of California at Los Angeles, Los Angeles, California, Department of Healthcare Policy and Research, School of Medicine, Virginia Commonwealth University, Richmond, Virginia (current affiliation).
⁵ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Private practice, Los Angeles, California (current affiliation).
⁶ Sansum Clinic, Santa Barbara, California.
⁷ Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, University of California at Los Angeles, Los Angeles, California.

PMID: 24766757
PMCID: PMC4002858
DOI: 10.15288/jsad.2014.75.447

Randomized Controlled Trial

The effect of an educational intervention on alcohol consumption, at-risk drinking, and health care utilization in older adults: the Project SHARE study

Susan L Ettner et al. J Stud Alcohol Drugs. 2014 May.

. 2014 May;75(3):447-57.

doi: 10.15288/jsad.2014.75.447.

Authors

Affiliations

¹ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Department of Health Policy and Management, School of Public Health, University of California at Los Angeles, Los Angeles, California.
² Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
³ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Ahava Center for Spiritual Living, Lexington, Kentucky (current affiliation).
⁴ Department of Health Policy and Management, School of Public Health, University of California at Los Angeles, Los Angeles, California, Department of Healthcare Policy and Research, School of Medicine, Virginia Commonwealth University, Richmond, Virginia (current affiliation).
⁵ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Private practice, Los Angeles, California (current affiliation).
⁶ Sansum Clinic, Santa Barbara, California.
⁷ Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, Department of Psychiatry and Biobehavioral Sciences, Neuropsychiatric Institute, University of California at Los Angeles, Los Angeles, California.

PMID: 24766757
PMCID: PMC4002858
DOI: 10.15288/jsad.2014.75.447

Abstract

Objective: The purpose of this study was to examine the effectiveness of a patient-provider educational intervention in reducing at-risk drinking among older adults.

Method: This was a cluster-randomized controlled trial of 31 primary care providers and their patients ages 60 years and older at a community-based practice with seven clinics. Recruitment occurred from July 2005 to August 2007. Eligibility was determined by telephone and a baseline mailed survey. A total of 1,186 at-risk drinkers were identified by the Comorbidity Alcohol Risk Evaluation Tool. Follow-up patient surveys were administered at 3, 6, and 12 months after baseline. Study physicians and their patients were randomly assigned to usual care (n = 640 patients) versus the Project SHARE (Senior Health and Alcohol Risk Education) intervention (n = 546 patients), which included personalized reports, educational materials, drinking diaries, physician advice during office visits, and telephone counseling delivered by a health educator. Main outcomes were alcohol consumption, at-risk drinking (overall and by type), alcohol discussions with physicians, health care utilization, and screening and intervention costs.

Results: At 12 months, the intervention was significantly associated with an increase in alcohol-related discussions with physicians (23% vs. 13%; p ≤ .01) and reductions in at-risk drinking (56% vs. 67%; p ≤ .01), alcohol consumption (-2.19 drinks per week; p ≤ .01), physician visits (-1.14 visits; p = .03), emergency department visits (16% vs. 25%; p ≤ .01), and nonprofessional caregiving visits (12% vs. 17%; p ≤ .01). Average variable costs per patient were $31 for screening and $79 for intervention.

Conclusions: The intervention reduced alcohol consumption and at-risk drinking among older adults. Effects were sustained over a year and may have been associated with lower health care utilization, offsetting screening and intervention costs.

Trial registration: ClinicalTrials.gov NCT00107640.

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Figures

**Figure 1**
Participant flow in Project SHARE (Senior Health and Alcohol Risk Education)

See this image and copyright information in PMC

References

1. Balsa AI, Homer JF, Fleming MF, French MT. Alcohol consumption and health among elders. The Gerontologist. 2008;48:622–636. - PubMed
1. Barnes AJ, Moore AA, Xu H, Ang A, Tallen L, Mirkin M, Ettner SL. Prevalence and correlates of at-risk drinking among older adults: The Project SHARE study. Journal of General Internal Medicine. 2010;25:840–846. - PMC - PubMed
1. Bhandari A, Wagner T. Self-reported utilization of health care services: Improving measurement and accuracy. Medical Care Research and Review. 2006;63:217–235. - PubMed
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1. Del Boca FK, Darkes J. The validity of self-reports of alcohol consumption: State of the science and challenges for research. Addiction, 98, Supplement. 2003;2:1–12. - PubMed

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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

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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

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