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Design and Sample Characteristics of the PRISM-E Multisite Randomized Trial to Improve Behavioral Health Care for the Elderly

Hongtu Chen

Brigham and Women’s Hospital, Harvard Medical School

Eugenie Coakley

John Snow, Inc.

Elizabeth C. McDonel Herr

U.S. Substance Abuse and Mental Health Services Administration

David W. Oslin

Ira Katz

University of Pennsylvania

Stephen J. Bartels

Dartmouth Medical School

James Maxwell

John Snow, Inc.

Edwin Olsen

Miami Veterans Affairs Medical Center

Keith M. Miles

New Hampshire–Dartmouth Psychiatric Research Center

Giuseppe Costantino

Sunset Park Mental Health Center

James H. Ware

Harvard School of Public Health

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. Method: 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. Discussion: These findings indicate the need for screening in primary care and for engaging older adults in treatment.

Key Words: mental health • elderly • primary care • method • drinking

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