COMPUTER ALGORITHMS FOR ALCOHOL DISORDERS IN THE ELDERLY

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This study is a randomized trial of the effectiveness and feasibility of the Computerized Alcohol-Related Problems System (CARPS), a self- administered screen to detect and report on non-hazardous, hazardous and harmful alcohol use in older adults. The CARPS consists of a scannable version of a reliable alcohol screen, a personalized Report of each patient's drinking classification, individualized alcohol education, and the capacity to store responses in a relational database. The CARPS was developed because of the paucity of effective and usable screens for older adults. In the elderly, one or two daily drinks may worsen common medical problems (e.g., depression) because of age-related changes and interactions between alcohol, medication-use and diminishing functional status. About 40% may be at risk; hospitalization rates for alcohol problems equal those for myocardial infarction. In this study, experimental primary care patients at a community practice will be randomly assigned to one of two experimental groups or a control. In Group 1, patients alone receive a Report; in Group 2, patients and physicians both receive Reports. The control group receives usual care. Effectiveness us evaluated by examining improvements in knowledge and self-efficacy and reductions in alcohol-related risks and health services utilization. Feasibility is evaluated by unobtrusive observations. PROPOSED COMMERCIAL APPLICATIONS: The CARPS can be used in all health settings to efficiently screen for and diagnose alcohol use disorders in the elderly. This includes physicians' offices and medical clinics, senior centers, and continuing care communities. Managed care organizations and health insurers are particularly concerned with efficient methods of detecting and preventing risks for health problems and will find the product beneficial, especially because no other product like it is available. The CARPS is user friendly. It can be used in quality improvement activities and research as well as in clinical care.