VINTAGEGood Health into Older Age

VINTAGEGood Health into Older Age

VINTAGEOverview

Aneurin Oweninfo@ias.org.uk

VINTAGEGood Health into Older Age

• Rationale of project:

• Ageing population of EU – growth in absolute numbers

• Alcohol use disorders common in older people

• 27% of 55+ consume 50g of alcohol at one sitting at least once per week

At present, there is no indication that light to moderate alcohol drinking would be harmful to cognition and dementia, and it is not possible to define a specific beneficial level of alcohol intake.

Road accident in the elderly: the next priority?

• Several Member States attribute recent increases in alcohol consumption, hospita- lisation and mortality to reductions in the price of alcohol and increased availability;

• Five Member States (Finland, Sweden, the UK, Latvia and Poland) report significant increases in alcohol related hospitalisations over the past 5–10 years, but two (Slovenia and Germany) report small reductions

• Only one country (Italy) has an alcohol consumption guideline for elderly adults (no more than one standard drink, or about 12 grams of pure alcohol, per day). The remaining Member States surveyed use the recommendation for all adults, which is typically no more than two standard drinks per day (or about 24 g of pure alcohol);

• Training programs to assist healthcare staff with the detection and management of alcohol problems among the elderly do not currently exist in most Member States, although three (Sweden, Finland and the UK) conduct programmes which touch on these issues;

•

• The numbers of older people are increasing.• Many use alcohol, tobacco and prescribed

medications. Some use illicit drugs, some gamble.

• Most of these behaviours are moderate and enjoyable. They should not be discouraged per se.

• Many use alcohol, tobacco and prescribed medications. Very few use illicit drugs, but many gamble (often by playing bingo).

• The extent of alcohol and other “addiction” problems amongst older people in the UK is unclear. Regular screening and more research are needed.

• Staff training is required to improve both detection and management of problems related to alcohol and other behaviours.

• Health professionals must ensure older people are aware of the possible interactions with alcohol and medication.

• More services for older people with alcohol and other problems are going to be needed in future.

•

‘Alcohol and Ageing’ – “Is alcohol a major threat to healthy ageing for the baby boomers?” – A Report by the Alcohol and Ageing Working Group, NHS Scotland

Recommendations

Key recommendation – Age-based sensible drinking limits should be developed

More research on the use of alcohol by the baby boomers should be conducted.

Education regarding alcohol targeted at the baby boomers should be provided

Training of heath and social care professionals in opportunistic screening and brief Interventions should be introduced

‘Unit of alcohol’ labelling of beverages

Increase in price of beverages containing alcohol via taxation in order to reduce consumption

EU Public Health Programme 2008 – 2011

- Promote healthy ageing

- Prevent harmful alcohol use among older people including the transition period from work to retirement

- Establish good practice and formulate prevention guidelines and policies

VINTAGEGood Health into Older Age

VINTAGEGood Health into Older Age

VINTAGEEvaluation report - referee’s conclusion

VINTAGEEvaluation report - referee’s conclusion

This project is of high relevance to the implementation EU strategy to support Member States in reducing alcohol related harm, to the Work plan and to Community health programme. Scientific reviews on health and alcohol consumption in elderly and on effective practices will contribute to the knowledge and good practice exchange at EU and country level.

The project could also have potential impact on the health of citizens, health services utilization, sustainability of health systems and consequently on reduction of health inequalities.

Health Scotland (2006) Alcohol and Ageing, A Report by the Alcohol & Ageing Working Group, Edinburgh: NHS Health Scotland.

Hospital Episode Statistics –changes in selected hospital admissions age 65+ (2002 – 2007)

VINTAGEObjectives and Methods

VINTAGEObjectives and Methods

The main aim of VINTAGE is to improve knowledge and to build capacity, at European, national and local level, in order to prevent the harmful use of alcohol among elderly subjects: - provide evidence-based information on the impact of alcohol on health and well-being systematic reviews

collect examples of best practices, effective policies and programmes regarding the reduction of harmful alcohol use structured template

active dissemination of reports, best practices, relevant laws and infrastructures specific website

Definition adopted in the collection of PPbPCollected examples include a wide range of activities,

for example laws and policies to reduce BAC level in older people, restrictions to alcohol access, information messages and campaigns, or alcohol prevention and treatment services, sensitive to the elder's need, including the transition from work to retirement Project any action (research, prevention, etc.) endorsed with a clear start and end point

Programmea group of integrative, continuously implemented actions

bPracticesintervention approaches that, through experience or research, have been proven to reliably lead to a desired result (in a specific target group of people)

Evaluation Plan

An external evaluation has been undertaken, following a case study evaluation methodology: Process evaluation

analysis of written documentation (meeting notes and minutes, reports, etc.)

network survey to project staff and members, assessment of quality of information

Output evaluation review of project outputs, in terms of scientific accuracy,

readability, usability and ease of access, by a panel of selected scientists

Outcome evaluation assessment of long-term increased health and well-beeing

of elderly subjects through 3 intermediate measures (extent of dissemination, hits to websites and numbers of documents downloaded, stakeholders intention of modifying existing policies and practices)

VINTAGE Main Partners

VINTAGE Main Partners

Maastricht University UNIMAAS Onno van Schayck

Gencat GENCAT Joan Colom

Institute of Public Health Slovenia

IVZ Sandra Rados

Institute of Public Health Czech Rep.

SZU Hana Sovinova

Stakes – Finlandia STAKES Salme Ahlstrom

Institute of Alcohol Studies

IAS Andrew McNeill

VINTAGETiming of Work Packages (WP and Deliverables (D)

VINTAGETiming of Work Packages (WP and Deliverables (D)

WP lead partner

Month

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

WP1 - Project coordination Istituto Superiore di Sanita

    MC D1          D4 MC

          MC   D7

WP2 - Results dissemination Istituto Superiore di Sanita

    W D2   D3                        

WP3 - Project evaluation Istituto Superiore di Sanita

                                  D8

WP4 - Evidence based Maastricht University

                      D5            

WP5 - Experience based Generaltat de Cataluna

                              D6 D    

Duration of the project 18 months: 01.03.09 – 31.08.10

All deliverables will be submitted to the Executive Agency for Health and Consumers (EAHC)D1 Protocol D7 Final technical and financial report MC Management committee meetingD2 Dissemination plan D8 Evaluation report W Launch of websiteD3 Website dissemination D Launch of databaseD4 Interim technical and financial reportD5 Report on alcohol and older peopleD6 Report on best practices

VINTAGEWP3 – Evaluation of the project

VINTAGEWP3 – Evaluation of the project

An external evaluation will be undertaken, following a case study standard methodology

Process evaluation

✓Analysis of written documentation (meeting notes and minutes, reports etc.)

✓Network survey to project staff and members

Output evaluation

✓Review of project deliverables in terms of scientific accuracy, readability, usability and ease of access

Outcome evaluation

✓Assessment of long-term increased health and well-being of elderly subjects

✓3 intermediate measures (dissemination, hits to websites and numbers of documents downloaded, stakeholders’ intention of modifying existing policies and practices)

VINTAGEResponses from the UK

VINTAGEResponses from the UK

Older adults’ Support Service in Southwark

Dr Tony Rao

Best practice

o Dual diagnosis assessment and home-based service including brief interventionso and harm minimization in the context of a support and recovery model

o Additional training for staff

o Patient Information Leaflet for R C Psych

o Clinical advisory Group (Institute of Psychiatry) hopefully will take on research and development in this area

VINTAGEResponses from the UK

VINTAGEResponses from the UK

Alcohol and Older People

Richard Cyster

Project, Welling, Kent

o Working in conjunction with Mental Health and other Social and Primary Care Teams

o Developing older people’s networks – community and care agencies to extend the support available

o Additional training to promote awareness, knowledge and skills

o Caseload and weekly treatment group

VINTAGEResponses from the UK

VINTAGEResponses from the UK

Alcohol Services Lifestyles Team

Dr Lynn Owens, Liverpool PCT

Best practice

oEarly identification of the role of alcohol in hospital attendance

oProvide timely effective interventions

oIncrease confidence of contemporaneous care givers

oReduce perception of stigma

oPart of a service model recognising the risk for older people

VINTAGEResponses from the UK

VINTAGEResponses from the UK

CASA Older People’s service

Michael Fox, London

Project

o Counselling, group work and other forms of support to people aged 55+ (no upper age limit)

o Training of other professionals

o Specialist service now replaced by generic provision

VINTAGE-DISSEMINATION-

VINTAGE-DISSEMINATION-

To ensure that information about and the main findings of the project (all relevant reports, examples of best practices, and relevant laws and infrastructures) are actively disseminated along with relevant key findings and implications for policy and programme development, to those responsible for alcohol policy and programme development, including those working in the fields of health and welfare of older people at the European, country, regional and municipal levels, in order to help build the capacity and knowledge of such personnel in making informed and evidence-based decisions.

VINTAGEWP2 – Dissemination of results

VINTAGEWP2 – Dissemination of results

Electronic dissemination of the project main findings (reports, examples of best practices, laws and infrastructures) through a specific website:

Hosted by ISS, in partnership with DHS (Pathways for Health Project website) and UiB (HP-Source website of infrastructures for alcohol policy)

Links with all websites of associated and collaborating partners

Elaboration of a dissemination strategy to a list serve of relevant stakeholders (governmental, non-governmental and private organisations working in the field of older people)

INVITES MEMBER STATES TO

INVITES THE COMMISSION AND MEMBER STATES TO- include in existing information systems scientific data on alcohol consumption and harm

caused by harmful use of alcohol in the age group of 60 and above;

- develop and implement early identification and brief intervention procedures in primary and elderly health care and in school health settings

"THE COUNCIL OF THE EUROPEAN UNION:NOTES: - that older adults (aged 60 and above) are more sensitive to the effects of harmful use of alcohol than other adults, and that alcohol-related deaths among older adults have increased markedly over the last ten years, and that in some cases the death rate has more than doubled;