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Open Access Publications from the University of California

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

  • Author(s): Ettner, SL
  • Xu, H
  • Duru, OK
  • Ang, A
  • Tseng, CH
  • Tallen, L
  • Barnes, A
  • Mirkin, M
  • Ransohoff, K
  • Moore, AA
  • et al.

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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 identifi ed 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 offi ce 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 signifi cantly 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.

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