NEW YORK (Reuters Health) - A Florida state-funded screening and intervention program helped identify cases of medication, alcohol, and other substance misuse among elders often overlooked by "traditional" treatment systems, researchers report.
The program, based on similar projects in other states, is unique in that it screens and serves older adults where they live or receive other services, for example, in senior centers, at health fairs and in retirement communities, note Dr. Lawrence Schonfeld, at the University of South Florida in Tampa and colleagues.
"People participating in the program, completing the sessions, and followed-up demonstrated lowered risk for the substances and often a decrease in depression scores," Schonfeld told Reuters Health.
Schonfeld and colleagues developed the Florida Brief Intervention and Treatment for Elders (BRITE) project to assess residents 60 years or older for substance misuse and associated risk for depression and suicide, they report in the American Journal of Public Health.
Elders who were identified as at-risk were offered up to five in-home intervention sessions to educate them on the risks of substance misuse and provide them with strategies to change their behavior.
Over 3 years, the program screened 3,497 residents (69 percent female), who were 75 years old, on average. Fifty-four percent lived alone and 21 percent lived with a spouse.
Overall, 26 percent of the interventions involved misuse of prescription and over-the-counter medications, and 1 percent involved misuse of illicit drugs. Ten percent of the study group screened positive for alcohol misuse.
A total of 64 percent also screened positive for depression. The investigators noted a significant association between symptoms of depression and alcohol and prescription medication misuse among the elders.
These results suggest the BRITE program is useful in identifying "hidden" cases of substance misuse among Florida's elder population.
Moreover, Schonfeld's team found elders who underwent screening and brief interventions had decreases in depression, alcohol misuse and medication misuse when discharged from the program.
The investigators are currently analyzing data from an expansion of this large-scale, elder-friendly screening and intervention program.
SOURCE: American Journal of Public Health, July 2009.
