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.
Brigham and Women's Hospital, Harvard Medical School, USA.
Sue E
SE
Levkoff
Hongtu
H
Chen
Eugenie
E
Coakley
Elizabeth C McDonel
EC
Herr
David W
DW
Oslin
Ira
I
Katz
Stephen J
SJ
Bartels
James
J
Maxwell
Edwin
E
Olsen
Keith M
KM
Miles
Giuseppe
G
Constantino
James H
JH
Ware
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