Gaining Recovery in Addiction for Community Elders (GRACE) Project: The Impact of Age-Specific Care on Clinical Outcomes and Health Care Resource Utilization in Older Adults With Substance Use Disorder in an Interprofessional Addiction Clinic

Author:

Schachman Kathleen A.1ORCID,Macomber Catherine A.2,Mitchell Matthew L.3,Brown Jill M.4,Scott Jennifer L.5ORCID,Darr Rachel L.6ORCID,Fabbro Mindy A.7ORCID,Morrone William R.8,Peckham Kari A.9,Charbonneau-Ivey Trisha K.10

Affiliation:

1. Kathleen A. Schachman, PhD, FNP-BC, PMHNP-BC, FIAAN, FAANP, Saginaw Valley State University, University Center, MI, USA

2. Catherine A. Macomber, PhD, LMSW, Saginaw Valley State University, University Center, MI, USA

3. Matthew L. Mitchell, DHA, LMSW, MBA, CAADC, CCS, Saginaw Valley State University, University Center, MI, USA

4. Jill M. Brown, PhD, MOST, OTRL, Saginaw Valley State University, University Center, MI, USA

5. Jennifer L. Scott, DNP, FNP-BC, PMHNP-BC, Saginaw Valley State University, University Center, MI, USA

6. Rachel L. Darr, PhD, RD, CSSD, Saginaw Valley State University, University Center, MI, USA

7. Mindy A. Fabbro, DNP, FNP-BC, PMHNP-BC, Saginaw Valley State University, University Center, MI, USA

8. William R. Morrone, DO, MPH, MS, FACOFP, Recovery Pathways, LLC, Bay City, MI, USA

9. Kari A. Peckham, EMT-B, CADC, Saginaw Valley State University, University Center, MI, USA

10. Trisha K. Charbonneau-Ivey, BA, MSHAL, Saginaw Valley State University, University Center, MI, USA

Abstract

Background: The prevalence of substance use disorders (SUDs) in older adults has been increasing, necessitating tailored and effective addiction care for this aging demographic. Aims: The purpose of this study was to assess the impact of age-specific, interprofessional addiction care on clinical outcomes and health care resource utilization in older adults with SUD. Methods: This quasi-experimental study directly compares patients enrolled in the Gaining Recovery in Addiction for Community Elders (GRACE) Project, an interprofessional age-specific addictions treatment program, with age-matched older adults who received conventional “treatment as usual” (TAU). Through retrospective comparative analysis, substance use outcomes, mental and physical health improvements, and inappropriate use of emergency services were examined among 78 older adults with SUD. Results: Clinical outcomes and health care resource utilization were superior for older adults who received age-specific addictions care through the GRACE Project, as compared to mixed-age conventional “TAU.” GRACE patients had improved treatment adherence, fewer relapses, and longer treatment engagement. While both groups exhibited significant reductions in depression and anxiety scores, GRACE patients showed greater improvements. This group demonstrated superior control of both hypertension and diabetes. Importantly, they had fewer inappropriate emergency department visits and avoidable hospitalizations than conventional “TAU.” Conclusions: Addiction treatment delivered by an interprofessional team to meet the unique strengths and needs of older adults has the potential to improve treatment adherence and more favorable long-term outcomes in substance use, mental health, and chronic medical conditions. Nurses are poised to lead interprofessional teams to meet the growing demand for specialized addiction treatment and integrated care for older adults.

Funder

Health Resources and Services Administration

Michigan Health Endowment Fund

Publisher

SAGE Publications

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