Older adults in treatment for alcohol use disorders: service utilisation, patient characteristics and treatment outcomes

Dauber, Hanna; Pogarell, Oliver; Kraus, Ludwig; Braun, Barbara

doi:10.1186/s13011-018-0176-z

Cited by 31 publications

(30 citation statements)

References 32 publications

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“…Our results highlighted that older age (> 50) was associated with an increased likelihood of seeking/receiving treatment. Consistent with some previous studies [18,44], they nevertheless contradict findings from at least one other study [45].…”

Section: Discussionsupporting

confidence: 89%

Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach

et al. 2020

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Background:The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care.Methods: Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification. Results: Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66-8.85]), regular smoking (9.72[3.91-24.15]) and feeling discriminated against (2.35[1.10-5.05]) were independent levers to having sought/received care for AUD, while being aged < 50 and employment were independent barriers. The five predominant themes in PWAUD discourses emerging from the textual analysis were: drinking context, medical care, alcohol treatment, tobacco/ addiction and family. When triangulating results from the logistic regression and the textual analysis, two barriers (social drinking and difficulties with the medical care system), and two levers (family influence and tobacco addiction), emerged.Conclusion: These results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD.

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Section: Discussionsupporting

confidence: 89%

Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach

et al. 2020

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“…Older individuals in our study were less likely to receive pharmacotherapy for AUD than the 30-50 year old group. A similar finding has been found in other studies of health service use and treatment for substance use among older adults, despite positive treatment outcomes [35,36]. These findings point to an opportunity to improve access to care and broader treatment options for older patients with AUD.…”

Section: Plos Onesupporting

confidence: 85%

Use of pharmacotherapy for alcohol use disorder in Manitoba, Canada: A whole-population cohort study

et al. 2021

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Objective Update the evidence on use of pharmacotherapy for alcohol use disorder in a Canadian population. Methods Using whole-population administrative data from Manitoba, Canada, we identified all residents age 12+ who were first diagnosed with alcohol use disorder between April 1, 1996 and March 31, 2015, and compared characteristics of those who filled a prescription for naltrexone, acamprosate or disulfiram at least once during that period to those who did not fill a prescription for an alcohol use disorder medication. Results Only 1.3% of individuals with alcohol use disorder received pharmacotherapy (62.3% of prescriptions were for naltrexone, 39.4% for acamprosate, 7.5% for disulfiram). Most prescriptions came from family physicians in urban alcohol use disorder (53.6%) and psychiatrists (22.3%). Individuals were more likely to fill a prescription for alcohol use disorder medication if they lived in an urban vs rural environment (OR 2.25; 95% CI 1.83–2.77) or had a mood/anxiety disorder diagnosis vs no diagnosis (OR 2.40, 95% CI 1.98–2.90) in the five years before being diagnosed with alcohol use disorder. Conclusion Despite established evidence for the effectiveness of pharmacotherapy for alcohol use disorder, these medications continue to be profoundly underutilized in Canada.

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“…The mean age was 65.5 years (SD: 4.4; assessed at baseline). In terms of age and gender, the sample was comparable to national AUD patient data on OA from Germany and Denmark (Danish Health Data Authority, 2016; Dauber et al, 2018). At the 6-month follow-up, 54.2% reported past 30-day hazardous use, 66.8% heavy episodic drinking, and 55.8% a "slip."…”

Section: Demographic Information and Dsm-5 Aud Indicators At 6-month Follow-upmentioning

confidence: 80%

“…They experience prognostic factors at the end of treatment particular to their life stage (e.g., role transitions, spousal loss, and economic challenges) that differs from middle-age and early-adult life (Kuerbis, 2020). In addition, AUD among OA may be sustained from middle age, as OA with AUD are at substantial risk for AUD persistence (Dauber et al, 2018;Verges et al, 2012). These circumstantial factors in OA may either raise or lower the bar for a prognostic factor to have an impact.…”

Section: Introductionmentioning

confidence: 99%

Residual alcohol use disorder symptoms after treatment predict long‐term drinking outcomes in seniors with DSM‐5 alcohol use disorder

Behrendt

Kuerbis

Braun-Michl

et al. 2021

Alcoholism Clin & Exp Res

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Background: Risk of relapse within the first months after alcohol use disorder (AUD) interventions is substantial among older adults. For this vulnerable group, little information exists on how this risk is associated with residual DSM-5 AUD symptoms after treatment.Aims: To investigate among older adults who received short-term treatment for DSM-5 AUD (1) the prediction of drinking behaviors and quality of life 12 months after treatment initiation by 6-month DSM-5 AUD symptoms, AUD severity, and AUD remission, and (2) whether these DSM-5 AUD indicators provide prognostic information beyond that gained from 6-month alcohol use (AU) status. Methods:The international multicenter RCT "ELDERLY-Study" enrolled adults aged 60+ with DSM-5 AUD. We used data from the subsample of 323 German and Danish participants with complete DSM-5 AUD criterion information 6 months after treatment initiation (61% male; mean age = 65.5 years). AU was assessed with Form 90, DSM-5 AUD with the M.I.N.I., and quality of life with the WHOQOL-BREF. Generalized linear models were applied to investigate the associations between 6-month AUD indicators and 12-month AU and quality of life.Results: Independent of AU at 6 months, having 1 (vs. no) residual AUD symptom at 6 months predicted a 12-month "slip," defined as exceeding a blood alcohol concentration of 0.05% at least once during that time (OR: 3.7, 95% CI: 1.5 to 9.0), heavy episodic drinking, and hazardous use (p < 0.05). AUD remission was associated with

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Older adults in treatment for alcohol use disorders: service utilisation, patient characteristics and treatment outcomes

Cited by 31 publications

References 32 publications

Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach

Screening and care for alcohol use disorder in France: expectations, barriers and levers using a mixed-methods approach

Use of pharmacotherapy for alcohol use disorder in Manitoba, Canada: A whole-population cohort study

Residual alcohol use disorder symptoms after treatment predict long‐term drinking outcomes in seniors with DSM‐5 alcohol use disorder

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