Lay Description
Alcohol is the most prevalent form of substance use disorder and presents specific risks for older adults. The Hampshire Older Adults Alcohol Pathway (HOAAP) study builds on prior qualitative work from the Older Adults, Loneliness and Alcohol (OLA) project and adopts a quantitative, observational design. It aims to analyse routinely collected hospital data from all patients aged 18 and over admitted to University Hospital Southampton (UHS) since 2017. It does not involve any new treatments or require patients to take part directly.
The study will compare clinical outcomes between older adults (65+) and younger patients with increased-risk alcohol use. Key outcomes include hospital length of stay, nutritional status (based on in-hospital blood tests), prescribed medications, and broader health outcomes. Patients will be identified using a combination of alcohol screening data (AUDIT-C), clinical codes, and prescribing records.
Alcohol contributes causally to over 200 medical conditions. The risks are particularly pronounced in older adults due to increased susceptibility to medication interactions, comorbidities, falls, and frailty. Despite this, alcohol use in older adults remains under-recognised in acute care settings, and there is limited evidence on effective interventions for this population.
To date, only three studies—all conducted in the United States—have developed interventions specifically targeting older adults with alcohol-related needs. While these showed promising results in reducing alcohol consumption, their findings are not directly transferable to the UK context, where healthcare is universally accessible.
The scientific rationale for this study is based on the growing need to understand and address alcohol-related harms in older adults. National data show that nearly half of all alcohol-related hospital admissions now involve people aged 65 and over. In Southampton, alcohol-specific mortality rates are among the highest in England. Yet older adults are less likely to seek help, and services are often not designed with their needs in mind.