Evaluation of Australia’s first older adult-specific early intervention for reducing alcohol-related harm

Abstract

The aim of the present case study was to evaluate the service-wide implementation of Australia’s first older adult-specific early intervention called Older Wiser Lifestyles (OWL). OWL was designed to reduce alcohol consumption and alcohol-related harm among people identified as being at risk. OWL used the Australian Alcohol-Related Problems Survey (A-ARPS) to classify people’s drinking patterns as non-hazardous, hazardous or harmful. Participants of the present study were aged ≥60 years and consumed alcohol in the past month, although they did not require treatment for dependence. The Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) was used as a composite measure of alcohol consumption. Data were collected before intervention and 3 and 6 months after intervention. In all, 140 clients were screened and attended at least one appointment (54% male; mean (± s.d.) age 72.8±7.6 years). Generalised estimating equation (GEE) examined the correlations between the intervention groups, time point and outcomes of interest. At 6 months, significant reductions were observed in A-ARPS classification (P=0.001) and AUDIT-C scores (P=0.001) among all clients, regardless of the number of sessions or intervention group. These preliminary findings warrant a randomised clinical trial of the intervention. Until this is completed, Australian health care providers should still consider the early intervention to reduce the risk of alcohol consumption among older adults. What is known about this topic? Older Australians are increasingly drinking alcohol at levels that place them at risk of experiencing harm. Although early interventions have been developed overseas that have been shown to reduce risky drinking among older adults, no such program has been implemented in Australia. What does this paper add? We developed an early intervention program (OWL) that drew from and extended intervention protocols developed overseas. In particular, we added harm reduction as a component of the intervention. Harm reduction interventions do not appear to have been evaluated among older adults. The OWL program was evaluated and found to be associated with decreased levels of alcohol-related harm. What are the implications for practitioners? Older adults have different needs when it comes to considering risk of alcohol-related harm. Many are taking medications that interact with alcohol or have comorbid conditions that can be exacerbated by alcohol or more difficult to treat. Yet, many such individuals are not considered to be at risk due to poor screening among this population. The program we developed takes into account these age-specific factors and has been manualised. As such, it could be implemented by a variety of healthcare workers in numerous settings. We hope that practitioners are interested in trialling the program and that a randomised controlled trial is conducted to establish the efficacy of the program.