Design and sample characteristics of the PRISM-E multisite randomized trial to improve behavioral health care for the elderly.
OBJECTIVE
To describe the design of the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study and baseline characteristics of the randomized primary care patients with mental health problems and at-risk alcohol use.


METHODS
Adults aged 65 and older were screened at primary care clinics from 10 study sites throughout the United States. Those diagnosed for depression, anxiety, and/or at-risk alcohol consumption were randomized to either integrated or enhanced referral care.


RESULTS
Of the 23,828 participants, 14% had a positive assessment for depressive and/or anxiety disorders, and 6% had at-risk alcohol consumption diagnoses. Among patients with mental health diagnoses, there was a higher preponderance of younger ages, women, and ethnic minorities. Among patients with at-risk drinking, there was a higher preponderance of younger ages, Whites, and men.


CONCLUSIONS
These findings indicate the need for screening in primary care and for engaging older adults in treatment.
Levkoff
Sue E
SE
Brigham and Women's Hospital, Harvard Medical School, USA.
Chen
Hongtu
H
Coakley
Eugenie
E
Herr
Elizabeth C McDonel
EC
Oslin
David W
DW
Katz
Ira
I
Bartels
Stephen J
SJ
Maxwell
James
J
Olsen
Edwin
E
Miles
Keith M
KM
Constantino
Giuseppe
G
Ware
James H
JH
D000367:Age Factors; D000368:Aged; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D001521:Behavior Therapy; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data; D008962:Models, Theoretical; D009096:Multi-Institutional Systems; D011320:Primary Health Care / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D011795:Surveys and Questionnaires; D014481:United States