Costs of Preventing Alcohol Problems in Older Adults

预防老年人酗酒问题的成本

• 批准号: 6931643
• 负责人: SUSAN Louise ETTNER
• 金额: $ 63.78万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6931643
• 关键词: aging; alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse education; alcoholism /alcohol abuse information system; alcoholism /alcohol abuse prevention; behavioral /social science research tag; clinical research; computer assisted diagnosis; computer assisted instruction; computer assisted patient care; cost effectiveness; counseling; disease /disorder proneness /risk; education evaluation /planning; geriatrics; health care cost /financing; health care service utilization; high risk behavior /lifestyle; human old age (65+); human subject; medical complication; patient care personnel attitude; primary care physician; publications; quality of life

DESCRIPTION (provided by applicant): Alcohol use in the elderly is an increasingly important public health problem. Traditional interventions focus on abuse and dependence in younger persons. Alcohol-related risks and problems in older persons, however, may come from the interaction between alcohol and diminished health or medication use. The proposed study is a randomized trial of the effectiveness and cost-effectiveness of an integrated patient provider intervention to prevent harmful (presence of alcohol-related problems such as liver disease or depression) and hazardous alcohol use (risks for problems) in older adults. The intervention will include a tested computerized screening and education system that was developed especially for older adults and their providers, supplemented by a well-established intervention for physicians. The patient component uses the Computerized Alcohol-Related Problems Survey, which results in printed Patient and Physician Reports with classification of the patient as a harmful, hazardous or non-hazardous drinker and reasons for the classification. The Patient Report references a companion educational booklet developed for older adults. The provider component is based on a physician intervention with proven effectiveness. The proposed research design involves randomization of 28 primary care physicians in four clinics and their eligible patients aged 65+ to the intervention vs. "usual care." Specific aims are to (1) evaluate the comparative effectiveness of a patient and physician educational intervention to prevent harmful and hazardous alcohol use in the elderly, relative to usual care; (2) evaluate the comparative costs of the intervention, relative to usual care; and (3) evaluate the post-effectiveness of the intervention, relative to usual care. Effectiveness measures include whether patients engage in hazardous and harmful drinking and their health-related quality of life; proximal outcomes examined include knowledge and self-efficacy. The cost-effectiveness analysis of Aim 3 will performed only if the Aim 2 analyses show that the intervention group has higher net costs than the control arm; if the intervention is cost-saving with equally good outcomes, or cost-neutral with better outcomes, then the intervention is cost-effective by definition.

描述（由申请人提供）：老年人饮酒是一个日益重要的公共卫生问题。传统干预措施侧重于年轻人的虐待和依赖。然而，老年人与酒精相关的风险和问题可能来自酒精与健康状况下降或药物使用之间的相互作用。拟议的研究是一项随机试验，旨在评估患者提供综合干预措施的有效性和成本效益，以预防老年人出现有害（与酒精相关的问题，如肝病或抑郁症）和有害饮酒（问题风险）。干预措施将包括专门为老年人及其提供者开发的经过测试的计算机化筛查和教育系统，并辅以完善的医生干预措施。患者部分使用计算机酒精相关问题调查，生成打印的患者和医生报告，其中将患者分类为有害、危险或无害饮酒者以及分类的原因。患者报告引用了为老年人开发的配套教育手册。 提供者组件基于经过验证有效的医生干预。拟议的研究设计涉及对 4 个诊所的 28 名初级保健医生及其 65 岁以上符合资格的患者进行随机分组，分别接受干预措施和“常规护理”。具体目标是 (1) 评估患者和医生教育干预措施相对于常规护理的相对有效性，以防止老年人有害和有害饮酒； (2) 评估干预措施相对于常规护理的比较成本； (3) 相对于常规护理评估干预后的有效性。有效性衡量标准包括患者是否从事危险和有害的饮酒及其与健康相关的生活质量；检查的近期结果包括知识和自我效能。仅当目标 2 分析表明干预组的净成本高于对照组时，才会执行目标 3 的成本效益分析；如果干预措施能够节省成本并获得同样良好的结果，或者成本中性但获得更好的结果，那么根据定义，该干预措施是具有成本效益的。