Clinical trial NCT02236494: Study of an Emergency Department-based Intervention to Reduce Alcohol Misuse in Older Adults
Official title: Pilot Trial of Emergency Department Intervention and Referral for Alcohol Misuse in Older Adults
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Alcohol Abuse
Keywords: alcoholism
dangerous behavior
aged
emergency medicine
Lead sponsor: University of North Carolina, Chapel Hill
Sponsor class: OTHER
Collaborators: name: The American Geriatrics Society
name: National Institute on Aging (NIA)
name: Society for Academic Emergency Medicine
name: North Carolina Translational and Clinical Sciences Institute
First posted: 2014-09-10
Enrollment: 222
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This is a randomized trial to assess the value of an emergency department-based intervention to reduce hazardous alcohol use among older adults. We hypothesize that the intervention will result in a 25% reduction in the prevalence of hazardous alcohol use while the control group will only have a 5% reduction.

Detailed description: The goal of this project is to perform a pilot, randomized, controlled trial of a brief intervention and referral for treatment among older adults in the emergency department (ED) with alcohol misuse. The pilot data would then be used to design a larger study. The intervention for this trial will consist of a Brief Negotiation Interview (BNI) with a stratified referral for further treatment, compared with usual care. The BNI is a standardized, well-described intervention that has been implemented in a broad range of clinical settings but has not been specifically tested in older adults in the ED. Following the BNI, we will provide a referral for further care for the patient that is stratified by severity of alcohol misuse. Patients with hazardous or harmful alcohol use will follow-up with a primary care physician; patients with alcohol abuse or dependence will follow-up with an outpatient alcohol and substance abuse program; those at risk for complicated withdrawal will be recommended for inpatient treatment. In all cases we will contact the referral physician to help transition the patient's care, and ensure the patient receives a consistent message regarding their alcohol use across the different care settings.

Eligibility criteria: Inclusion Criteria:

* Age 65 and older
* Receiving care in the emergency department
* Hazardous alcohol use, defined as reporting drinking more than 7 drinks per week on an average week during the three months prior to the visit, and whether they have consumed more than three drinks on any given occasion.

Exclusion Criteria:

* Prisoner
* psychosis or psychiatric hold
* nursing home
* life-threatening condition
* current hospice care

Primary outcomes:
measure: Alcohol misuse
timeFrame: 6 months
measure: Subgroup analysis of patients who met hazardous alcohol use criteria based on time-line follow back method of assessing alcohol consumption
timeFrame: 6 months
Secondary outcomes:
measure: Alcohol misuse
timeFrame: 3 months, 12 months
measure: Function
timeFrame: 6,12 months
measure: Alcohol consumption
timeFrame: 3,6,12 months
measure: Alcohol abuse
timeFrame: 3,6,12 months
measure: General Health
timeFrame: 3,6,12 months
measure: Risk-taking behavior
timeFrame: 6,12 months
measure: Trauma
timeFrame: 6,12 months
measure: Healthcare Utilization
timeFrame: 6,12 months
Other outcomes:
Locations:
city: Chapel Hill
country: United States
facility: UNC Hospitals Emergency Department
state: North Carolina
Study officials:
affiliation: UNC Chapel Hill
name: Christina Shenvi, MD,PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: UNC Chapel Hill
name: Timothy F Platts-Mills, MD,MSc
role: PRINCIPAL_INVESTIGATOR
References: