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Understanding the psychosocial needs and trajectories of older adults (>64 years) with alcohol use disorder (AUD) from hospital back into community

Older man sitting in a pub

Lead applicant: Professor Julia Sinclair

Co-applicants: Dr Rebecca Band, Professor Jackie Bridges

Background

Over 200 physical and mental health conditions are caused by alcohol. In England, more people are being admitted to hospital with, and dying from, alcohol-related disease than ever before.

In 2018/19, 44.7% of all alcohol related admissions were for people over the age of 65 compared with 14% in 2010/11. In 2021,1563 patients were assessed by the Alcohol Care Team (ACT) at University Hospital Southampton, 43% of whom were over the age of 60.

We know that older adults can often feel more shame and stigma related to their alcohol use compared with younger people. This can create barriers to accessing help with existing community addiction services. Beyond this, very little is known about the reasons why older adults drink alcohol and how this may interact with other social factors like loneliness and social isolation. Further research is needed to understand the ways in which to best support older adults to seek help, and what interventions may best promote positive outcomes.  

Study Design

This study will recruit older people with alcohol use disorder (AUD) admitted to hospital in Wessex. A longitudinal observational design will be used, meaning that people in the study will be asked by the research team to complete questionnaires over time following admission into hospital.

This will help to understand the needs of the population.

There will be four main research aims:

  1. What are the personal characteristics of older adults with AUD?
  2. How do participants make sense of themselves in relation to their alcohol use?
  3. What happens to participants in the six months following a hospital admission?
  4. What factors what might prevent or encourage people from seeking help for their alcohol use?

Study Methods

The study will identify potential participants through the ACT in Southampton in the first instance. Around 40% of people seen over the age of 65 years. Clinicians working in ACTs have the skills and experience to sensitively identify and assess patients with comorbid alcohol use disorders

Discussion about the study and consent processes will be undertaken by the UHS clinical trials officer. Participants who are willing to be part of the study will complete a set of questionnaires in hospital. Well-established measures of alcohol use, quality of life, loneliness, collective efficacy and health service use will be collected. Participants will be asked to complete similar questionnaires again at 3 and 6 months. This will probably take place over the phone.

Health service use data will be collected for the 6 months after discharge to explore resource use.

Study Outcomes

The results from this study will be used to design specific ways to help older people with AUD.