Participation in a Substance Misuse Intervention in Post-acute Care Is Associated With More Optimal Rehabilitation Outcomes.

Abstract

Alcohol and substance misuse is prevalent among older adults, yet underdiagnosed and undertreated. More substance misuse intervention programs specifically designed for older adults and offered in various settings are needed. This project's objectives were to (a) provide a detailed description of a Geriatric Substance Abuse Recovery Program (GSARP) designed and implemented at post-acute rehabilitation units of a skilled nursing facility and (b) report findings of a study conducted to evaluate if GSARP participation among post-acute care patients with substance misuse issues can optimize rehabilitation outcomes (i.e., being discharged home vs. another setting). A pretest-posttest study design with data obtained from patients' electronic medical record upon facility admission, during post-acute stay, and after discharge (N = 271). Based on Andersen's model of health care utilization, we investigated which predisposing factors (e.g., ethnicity), enabling factors (e.g., cognition and social support), and need-related factors (e.g., activities of daily living functioning), as well as health behaviors (e.g., GSARP participation) predicted likelihood of being discharged home versus another discharge setting. Patients participating in the GSARP and patients who received social support from family members and friends during their post-acute stay were more likely to be discharged home. Patients with severe cognitive impairment were less likely to be discharged home. The GSARP eliminates some common barriers often encountered in the screening and delivery process of substance misuse interventions for older adults. Findings support the effectiveness of the GSARP in optimizing rehabilitation outcomes for older adults with substance misuse issues.