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Predictors of Adherence Within an Intervention Research Study of the At-Risk Older Drinker: PRISM-E

University of Pennsylvania, Department of Psychiatry, Section Geriatric Psychiatry, fzanjani{at}mail.med.upenn.edu

Cynthia Zubritsky, PhD

University of Pennsylvania, School of Medicine, Center for Mental Health Policy and Research

Marian Mullahy, MSS

University of Pennsylvania, School of Medicine, Center for Mental Health Policy and Research

David Oslin, MD

University of Pennsylvania, Department of Psychiatry, Section Geriatric Psychiatry, Philadelphia VAMC, VISN 4 Mental Illness, Research, Education and Clinical Center, Philadelphia Center of Excellence for Substance Abuse Treatment and Evaluation (CESATE)

The aim of this study was to determine predictors of research adherence and treatment initiation in at-risk older drinkers. This investigation was conducted at primary care clinics in the Philadelphia Veteran Affairs Medical Center and the University of Pennsylvania, participating sites in a larger multisite study trial (PRISM-E). Persons aged 65 and older with appointments at participating clinics were eligible for recruitment (n = 8367). Approximately half (n = 4000) consented to the study, of which 145 were identified as at-risk drinkers and 125 agreed to treatment. Slightly more than half of the patients who agreed to treatment attended a mental health visit. The results suggest that predictors of research adherence and treatment initiation vary across research stage. Principal predictors include age, mental health status, and at-risk drinking attributes. Moreover, there was evidence that an integrated care treatment model may be capable of improving treatment initiation in at-risk older drinkers who have no history of substance management behaviors. Future researchers can use the current findings to create mechanisms to improve research participation and treatment initiation and target participants with classifications of poor adherence.

Key Words: at-risk drinking • primary care • treatment • elderly

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