TY - JOUR
T1 - Linkage of VA and State Prescription Drug Monitoring Program Data to Examine Concurrent Opioid and Sedative-Hypnotic Prescriptions among Veterans
AU - Carlson, Kathleen F.
AU - Gilbert, Tess A.
AU - Morasco, Benjamin J.
AU - Wright, Dagan
AU - Otterloo, Joshua Van
AU - Herrndorf, Aldona
AU - Cook, Lawrence J.
N1 - Funding Information:
Joint Acknowledgment/Disclosure Statement: This research was supported by Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service, project # IIR15-091, Kathleen F. Carlson, Principal Investigator. The Portland Center to Improve Veteran Involvement in Care (CIVIC), a VA Center of Innovation, provided data programming resources for this work. None of the co-authors have any financial or other disclosures or conflicts of interest related to the material contained in this manuscript. Disclosures: None.
Funding Information:
Joint Acknowledgment/Disclosure Statement: This research was supported by Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service, project # IIR15-091, Kathleen F. Carlson, Principal Investigator. The Portland Center to Improve Veteran Involvement in Care (CIVIC), a VA Center of Innovation, provided data programming resources for this work. None of the co-authors have any financial or other disclosures or conflicts of interest related to the material contained in this manuscript. Disclosures: None. Disclaimers: The opinions expressed in this paper are those of the authors and do not necessarily reflect those of the US government, the US Department of Veterans Affairs, or other affiliated institutions.
Publisher Copyright:
© Health Research and Educational Trust
PY - 2018/12
Y1 - 2018/12
N2 - Objective: To examine the prevalence of concurrent Veterans Health Administration (VA) and non-VA prescriptions for opioids and sedative-hypnotic medications among post-9/11 veterans in Oregon. Data Sources: VA health care and prescription data were probabilistically linked with Oregon Prescription Drug Monitoring Program (PDMP) data. Study Design: This retrospective cohort study examined concurrent prescriptions among n = 19,959 post-9/11 veterans, by year (2014–2016) and by patient demographic and clinical characteristics. Veterans were included in the cohort for years in which they received VA outpatient care; those receiving hospice or palliative care were excluded. Concurrent prescriptions were defined as ≥1 days of overlap between outpatient prescriptions for opioids and/or sedative-hypnotics (categorized as benzodiazepines vs. non-benzodiazepines). Principal Findings: Among 5,882 veterans who filled opioid or sedative-hypnotic prescriptions at VA pharmacies, 1,036 (17.6 percent) filled concurrent prescriptions from non-VA pharmacies. Within drug class, 15.1, 8.8, and 4.6 percent received concurrent VA and non-VA opioids, benzodiazepines, and non-benzodiazepines, respectively. Veteran demographics and clinical diagnoses were associated with the likelihood of concurrent prescriptions, as was enrollment in the Veterans Choice Program. Conclusions: A considerable proportion of post-9/11 veterans receiving VA care in Oregon filled concurrent prescriptions for opioids and sedative-hypnotics. Fragmentation of care may contribute to prescription drug overdose risk among veterans.
AB - Objective: To examine the prevalence of concurrent Veterans Health Administration (VA) and non-VA prescriptions for opioids and sedative-hypnotic medications among post-9/11 veterans in Oregon. Data Sources: VA health care and prescription data were probabilistically linked with Oregon Prescription Drug Monitoring Program (PDMP) data. Study Design: This retrospective cohort study examined concurrent prescriptions among n = 19,959 post-9/11 veterans, by year (2014–2016) and by patient demographic and clinical characteristics. Veterans were included in the cohort for years in which they received VA outpatient care; those receiving hospice or palliative care were excluded. Concurrent prescriptions were defined as ≥1 days of overlap between outpatient prescriptions for opioids and/or sedative-hypnotics (categorized as benzodiazepines vs. non-benzodiazepines). Principal Findings: Among 5,882 veterans who filled opioid or sedative-hypnotic prescriptions at VA pharmacies, 1,036 (17.6 percent) filled concurrent prescriptions from non-VA pharmacies. Within drug class, 15.1, 8.8, and 4.6 percent received concurrent VA and non-VA opioids, benzodiazepines, and non-benzodiazepines, respectively. Veteran demographics and clinical diagnoses were associated with the likelihood of concurrent prescriptions, as was enrollment in the Veterans Choice Program. Conclusions: A considerable proportion of post-9/11 veterans receiving VA care in Oregon filled concurrent prescriptions for opioids and sedative-hypnotics. Fragmentation of care may contribute to prescription drug overdose risk among veterans.
KW - VA health care system
KW - Veterans
KW - data linkage
KW - dual use
KW - opioid safety, medication safety
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U2 - 10.1111/1475-6773.13025
DO - 10.1111/1475-6773.13025
M3 - Article
C2 - 30088271
AN - SCOPUS:85053247851
SN - 0017-9124
VL - 53
SP - 5285
EP - 5308
JO - Health Services Research
JF - Health Services Research
ER -