Towards Recovery Oriented Systems of Care for Older Persons with Alcohol Problem (ROSC-OPAP): Studies of Interventions Across the Care Continuum

Research Problem and Specific QuestionsMost older people with alcohol problem (OPAP) have physical and mental health comorbidities.

They also face social problems such as unstable housing, unemployment and loneliness, underscoring their multiple care needs from social and healthcare services.

There is, however, a growing concern whether the interventions they receive are recovery-oriented and whether they promote self-determination and choice in this demographic.

This project, using the framework for recovery-oriented systems of care (ROSC), aims to:identify interventions OPAP access from social and healthcare servicesevaluate the effectiveness of these interventions in reducing alcohol use and improving quality of lifeinvestigate the treatment experiences of OPAP and staff assessments of service users´ performanceData and MethodThis multimethod project includes four studies on adults, aged 50+ years, who accessed treatment for problem drinking from social services and/or healthcare between 2007-2023.

Data include municipal addiction assessment and treatment data including free text data from clients and caseworkers, quality register for dependency, social and health registers from Socialstyrelsen, Försäkringskassan and SCB.

Descriptive statistics, multivariable regression, mediation and moderation models will map the interventions and test their association with individual factors including gender, age, problem severity and comorbidities.

Difference in Differences, survival analysis and latent variable modeling assess intervention effects on alcohol use, quality of life and socioeconomic and health trajectories. A mixed-method analysis explores treatment experiences and staff assessments of service users´ performance.

Societal relevance and UtilizationIn Sweden, over 25% of individuals seeking treatment for alcohol problems are older adults (50+ yrs old) with complex care needs. ROSC-OPAP contributes to a learning and recovery-oriented addiction treatment system.

It generates new knowledge on intervention effectiveness from real-world data including patient reported outcomes and experiences and informs quality improvement works and outcome-driven intervention delivery.Plan for project realizationROSC-OPAP is carried out over three years in collaboration with a user group, an IT company and a multidisciplinary advisory committee consisting of researchers and practitioners.

The budget covers salaries for the applicant, project assistant and operating costs.