Screening for alcohol misuse in elderly primary care patients: a systematic literature review

Berks, John; McCormick, Ross

doi:10.1017/s1041610208007497

Cited by 91 publications

(55 citation statements)

References 41 publications

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“…The AUDIT-C has good sensitivity and specificity for hazardous and harmful drinking in the elderly. 229 We summarised the AUDIT-C as a continuous variable.…”

Section: Alcohol Consumptionmentioning

confidence: 99%

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Walters

Frost

Kharicha

et al. 2017

Health Technol Assess

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Background Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. Objectives (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT). Design Evidence reviews, qualitative studies, intervention development and a feasibility RCT with process evaluation. Intervention development Two systematic reviews (including systematic searches of 14 databases and registries, 1990–2016 and 1980–2014), a state-of-the-art review (from inception to 2015) and policy review identified effective components for our intervention. We collected data on health priorities and potential intervention components from semistructured interviews and focus groups with older people (aged 65–94 years) (n = 44), carers (n = 12) and health/social care professionals (n = 27). These data, and our evidence reviews, fed into development of the ‘HomeHealth’ intervention in collaboration with older people and multidisciplinary stakeholders. ‘HomeHealth’ comprised 3–6 sessions with a support worker trained in behaviour change techniques, communication skills, exercise, nutrition and mood. Participants addressed self-directed independence and well-being goals, supported through education, skills training, enabling individuals to overcome barriers, providing feedback, maximising motivation and promoting habit formation. Feasibility RCT Single-blind RCT, individually randomised to ‘HomeHealth’ or treatment as usual (TAU). Setting Community settings in London and Hertfordshire, UK. Participants A total of 51 community-dwelling adults aged ≥ 65 years with mild frailty. Main outcome measures Feasibility – recruitment, retention, acceptability and intervention costs. Clinical and health economic outcome data at 6 months included functioning, frailty status, well-being, psychological distress, quality of life, capability and NHS and societal service utilisation/costs. Results We successfully recruited to target, with good 6-month retention (94%). Trial procedures were acceptable with minimal missing data. Individual randomisation was feasible. The intervention was acceptable, with good fidelity and modest delivery costs (£307 per patient). A total of 96% of participants identified at least one goal, which were mostly exercise related (73%). We found significantly better functioning (Barthel Index +1.68; p = 0.004), better grip strength (+6.48 kg; p = 0.02), reduced psychological distress (12-item General Health Questionnaire –3.92; p = 0.01) and increased capability-adjusted life-years [+0.017; 95% confidence interval (CI) 0.001 to 0.031] at 6 months in the intervention arm than the TAU arm, with no differences in other outcomes. NHS and carer support costs were variable but, overall, were lower in the intervention arm than the TAU arm. The main limitation was difficulty maintaining outcome assessor blinding. Conclusions Evidence is lacking to inform frailty prevention service design, with no large-scale trials of multidomain interventions. From stakeholder/public perspectives, new frailty prevention services should be personalised and encompass multiple domains, particularly socialising and mobility, and can be delivered by trained non-specialists. Our multicomponent health promotion intervention was acceptable and delivered at modest cost. Our small study shows promise for improving clinical outcomes, including functioning and independence. A full-scale individually RCT is feasible. Future work A large, definitive RCT of the HomeHealth service is warranted. Study registration This study is registered as PROSPERO CRD42014010370 and Current Controlled Trials ISRCTN11986672. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 73. See the NIHR Journals Library website for further project information.

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“…The AUDIT-C has good sensitivity and specificity for hazardous and harmful drinking in the elderly. 229 We summarised the AUDIT-C as a continuous variable.…”

Section: Alcohol Consumptionmentioning

confidence: 99%

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Walters

Frost

Kharicha

et al. 2017

Health Technol Assess

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“…Alcohol consumption is a major risk factor for mortality and morbidity throughout the life span (Berks and McCormick 2008;Rehm et al 2004), and during adolescence it is associated with a range of adverse consequences, including academic problems, future drinking and drugs use, delinquent behaviour (Ellickson et al 2003), motor vehicle crashes (Shope and Bighman 2008), and physical and emotional problems (Tomlinson et al 2004). More specifically, drunkenness has been associated with adverse consequences and health problems such as fatal and non-fatal injuries, blackouts, suicide attempts, unintended pregnancy, sexually transmitted diseases, academic failure, and violence (Perkins 2002).…”

Section: Introductionmentioning

confidence: 99%

Gender convergence in adolescent drunkenness in different Italian regions

Vieno

Lenzi

Santinello

et al. 2013

Int J Public Health

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Behaviour in School Aged Children" (HBSC) trans-national study. The sample was comprised of 13,174 Italian middle and secondary school students (50.3% girls). Data were collected through a self-report questionnaire. Data on drunkenness and demographic characteristics were used for this study. Trends were determined using the Gamma statistics. Conclusions: Future researches and prevention programs on drunkenness should give more consideration to geographical-cultural differences not only by comparing or taking in consideration different countries but also by comparing different regions in the same country.

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“…Por lo tanto, en muestras de pacientes psiquiátricos, un punto de corte de 1 proporciona una sensibilidad alta con suficiente especificidad. Es más, aunque varios estudios han usado un valor de corte de 2 (dos o más respuestas afirmativas) en la CAGE (Berks y McCormick, 2008;Castells y Furlanetto, 2005;Fiellin et al, 2000;Hearne et al, 2002;Mayfield et al, 1974;Paz Filho et al, 2001), varios resultados publicados sugieren que el mejor punto de corte para el cuestionario CAGE con pacientes psiquiátricos es 1 (Agabio et al, 2007;Bradley, Bush, McDonell, Malone, y Fihn, 1998;McGarry y Cyr, 2005;Ogborne, 2000). Respecto de la relación con edad y género, también se ha fijado que el punto de corte para la definición de casos debería ser de una respuesta positiva, dado que este valor puede mejorar la sensibilidad para mujeres y personas mayores (Bradley et al, 1998;Cherpitel, 1995;Jones, Lindsey, Yount, Soltys, y Farani-Enayat, 1993).…”

Section: Discussionunclassified

“…La literatura apoya el uso de instrumentos de cribado para aumentar la detección temprana de TUA (Barnaby, Drummond, McCloud, Burns, y Omu, 2003;Fiellin, Reid, y O'Connor, 2000). El cuestionario CAGE es breve, sencillo de aplicar, y ampliamente usado como instrumento de cribado para detectar TUA en la población general (Baltieri y de Andrade, 2008;Curran, Gawley, Casey, Gill, y Crumlish, 2009) así como en muestras clínicas (Berks y McCormick, 2008;Fiellin et al, 2000;Lejoyeux et al, 2012;Mitchell, Bird, Rizzo, Hussain, y Meader, 2014) y psiquiátricas (Castells y Furlanetto, 2005;Derks, Vink, Willemsen, van den Brink, y Boomsma, 2014;Etter y Etter, 2004;Kim, Shin, Kim, y Lee, 2016;Lejoyeux et al, 2014;Malet, Schwan, Boussiron, Aublet-Cuvelier, y Llorca, 2005;Oe et al, 2016;Tang et al, 2016). También se ha utilizado para valorar pacientes geriátricos (Draper et al, 2015;León-Muñoz et al, 2015) y en estudios de género (de Oliveira, Kerr-Correa, Lima, Bertolote, y Santos, 2014).…”

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Cribaje de trastornos por uso de alcohol en pacientes psiquiátricos ambulatorios: influencia de género, edad, y diagnóstico psiquiátrico

et al. 2017

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Screening for alcohol misuse in elderly primary care patients: a systematic literature review

Cited by 91 publications

References 41 publications

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Gender convergence in adolescent drunkenness in different Italian regions

Cribaje de trastornos por uso de alcohol en pacientes psiquiátricos ambulatorios: influencia de género, edad, y diagnóstico psiquiátrico

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