The Alcohol‐Related Problems Survey: Identifying Hazardous and Harmful Drinking in Older Primary Care Patients

Abstract

Physicians are urged to screen for alcohol-related problems in older persons. The ARPS reliably identifies harmful, hazardous, and nonhazardous drinking in older adults resulting most often from the interaction between alcohol and disease and medication use.

The Effect of an Educational Intervention on Alcohol Consumption, At-Risk Drinking, and Health Care Utilization in Older Adults: The Project SHARE Study

“…The data from this trial compare favorably with those from the three other published trials in primary care aimed at reducing some aspect of alcohol consumption among older adults (Fink et al, 2002a;Fleming et al, 1999;Moore et al, 2011). Project GOAL (Guiding Older Adult Lifestyles) was a randomized trial testing the effi cacy of brief physician advice and follow-up nurse calls in reducing alcohol use in problem drinkers ages 65 and older (Fleming et al, 1999).…”

“…Eligible, interested patients were mailed an information sheet (required by the UCLA Institutional Review Board in lieu of standard informed consent forms when surveys are not conducted in person) and a baseline survey that included the CARET, an updated and revised version of the AlcoholRelated Problems Survey (Barnes et al, 2010;Grimshaw et al, 2001;Fink et al, 2002aFink et al, , 2002bMoore et al, 2000Moore et al, , 2002, which identifi es older adults at risk for harm from their alcohol consumption for any of the following seven reasons: (a) exceeding a particular quantity and frequency of alcohol use, (b) heavy episodic drinking (four or more drinks at least once a week), (c) driving within 2 hours of having had three or more drinks, (d) concern from another person about the patient's drinking, (e) alcohol use with comorbidities (e.g., gout, depression, ulcer disease), (f) alcohol use with symptoms (e.g., nausea, falls, insomnia), or (g) alcohol use with medications (e.g., antidepressants, sedatives). Examples of at-risk drinkers include people who drink (a) four drinks (or more) per occasion at least weekly, (b) two drinks per day and take a sedative three to four times a week, or (c) two drinks at least twice a week and have memory problems.…”

Drinking Patterns of Older Adults with Chronic Medical Conditions

“…Even in the absence of alcohol disorders, at-risk drinking may place many elders with chronic conditions at increased risk for injury and medical complications. 22,24 To our knowledge, there is a lack of national estimates for the prevalence of alcohol consumption in the older Medicare population with selected chronic conditions. Therefore, we used nationally representative Medicare data to: 1) estimate the prevalence of drinking patterns for older adults with one or more of seven common chronic conditions; and 2) estimate the prevalence of drinking patterns by levels of chronic illness burden and functional limitations.…”

The Prevalence of Harmful and Hazardous Alcohol Consumption in Older U.S. Adults: Data from the 2005–2008 National Health and Nutrition Examination Survey (NHANES)

“…11,22,23 Its development, psychometric properties, and research use are well-documented. 10,11,[22][23][24][25][26] Briefly, Moore and colleagues used the Longitudinal Expert All Data (LEAD) standard 27 to evaluate the concurrent validity of ARPS, and found in one study that the ARPS had a sensitivity of 0.93 and a specificity of 0.66 for hazardous or harmful alcohol consumption, 22 and in another study, a sensitivity of 0.82 and specificity of 0.82. 23 The ARPS uses World Health Organization terminology 28 The ARPS algorithm first considers a person's reported quantity and frequency of consumption in relation to each of 63 factors, including medical problems, medication use, symptoms, binge drinking, sex, and functional status.…”