Transcript Good Health into Older Age

VINTAGE
Good Health into Older Age
VINTAGE
Overview
Aneurin Owen
[email protected]
VINTAGE
Good 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?
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Several Member States attribute recent
increases in alcohol consumption, hospitalisation 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;
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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
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Key recommendation – Age-based sensible drinking limits should be developed
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More research on the use of alcohol by the baby boomers should be conducted.
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Education regarding alcohol targeted at the baby boomers should be provided
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Training of heath and social care professionals in opportunistic screening and brief
Interventions should be introduced
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‘Unit of alcohol’ labelling of beverages
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Increase in price of beverages containing alcohol via taxation in order to reduce
consumption
VINTAGE
Good Health into Older Age
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
VINTAGE
Evaluation 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)
VINTAGE
Objectives 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 PPbP
Collected 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
Programme
a group of integrative, continuously implemented actions
bPractices
intervention 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
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
VINTAGE
Timing of Work Packages (WP and Deliverables (D)
Duration of the project 18 months: 01.03.09 – 31.08.10
WP
lead partner
Month
1
2
3
4
WP1 - Project coordination
Istituto Superiore di Sanita
MC
D1
WP2 - Results dissemination
Istituto Superiore di Sanita
W
D2
5
6
7
8
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10
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12
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14
D4
MC
15
16
MC
17
18
D7
D3
WP3 - Project evaluation
Istituto Superiore di Sanita
D8
WP4 - Evidence based
Maastricht University
D5
WP5 - Experience based
Generaltat de Cataluna
D6 D
All deliverables will be submitted to the Executive Agency for Health and Consumers (EAHC)
D1
D2
D3
D4
D5
D6
Protocol
Dissemination plan
Website dissemination
Interim technical and financial report
Report on alcohol and older people
Report on best practices
D7
D8
Final technical and financial report
Evaluation report
MC
W
D
Management committee meeting
Launch of website
Launch of database
VINTAGE
WP3 – Evaluation of the project
An external evaluation will be undertaken, following a case study standard methodology
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Process evaluation
✓Analysis of written documentation (meeting notes and minutes, reports etc.)
✓Network survey to project staff and members
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Output evaluation
✓Review of project deliverables in terms of scientific accuracy, readability, usability
and ease of access
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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)
VINTAGE
Responses from the UK
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Older adults’ Support Service in Southwark
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Dr Tony Rao
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Best practice
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Dual diagnosis assessment and home-based service including brief interventions
and harm minimization in the context of a support and recovery model
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Additional training for staff
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Patient Information Leaflet for R C Psych
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Clinical advisory Group (Institute of Psychiatry) hopefully will take on research and
development in this area
VINTAGE
Responses from the UK
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Alcohol and Older People
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Richard Cyster
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Project, Welling, Kent
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Teams
Working in conjunction with Mental Health and other Social and Primary Care
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the
Developing older people’s networks – community and care agencies to extend
support available
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Additional training to promote awareness, knowledge and skills
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Caseload and weekly treatment group
VINTAGE
Responses 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
VINTAGE
Responses from the UK
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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
-DISSEMINATIONTo 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.
VINTAGE
WP2 – Dissemination of results
Electronic dissemination of the project main findings (reports, examples
of best practices, laws and infrastructures) through a specific website:
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Hosted by ISS, in partnership with DHS (Pathways for Health Project website)
and UiB (HP-Source website of infrastructures for alcohol policy)
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Links with all websites of associated and collaborating partners
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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)
"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;
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