In This Issue: Improving Opioid Safety
State Prescription Monitoring Program to Evaluate Concurrent VA and Non-VA Opioid Prescriptions
Controlled prescription drug overdose, primarily from opioids, is a leading cause of death in the United States. Moreover, Veterans who use VA healthcare have twice the risk of medication overdose deaths than non-Veterans, but reasons for the increased risk are unknown. It is possible that Veterans who receive VA prescriptions simultaneously receive controlled prescriptions (e.g., opioids, benzodiazepines) from non-VA prescribers. State prescription drug monitoring programs (PDMPs) can help reduce prescription drug overdose by providing data on controlled medications across providers and systems. However, little is known about the prevalence of dual VA-community prescriber use among Veterans, their full range of medication-related adverse events (i.e., those treated inside or outside VA), and mechanisms to increase use of state PDMPs within VA.
This ongoing HSR&D study (2016–2019) will:
Investigators will link VA data to multiple state databases to identify controlled prescriptions (VA and community) that OEF/OIF/OND Veterans are receiving, as well as their risk of overdose and other adverse events treated inside or outside VA. Data from 2011 – the year the Oregon PDMP was implemented – through 2016 will be used to identify patterns, rates, and risk factors for dual VA/community prescriber use, as well as fatal and nonfatal medication-related adverse events. Investigators will interview and survey Oregon VA prescribers about barriers and facilitators to using the state PDMP. They will also examine organizational and patient factors associated with VA-documented PDMP queries among Veterans receiving long-term opioid therapy (LTOT) in VISN 20.
Principal Investigator: Kathleen Carlson, MD, PhD, is part of HSR&D’s Center to Improve Veteran Involvement in Care (CIVIC) in Portland, OR.
Publications: Carlson K, Gilbert T, Morasco B, et al. Linkage of VA and state prescription drug monitoring program data to examine concurrent opioid and sedative-hypnotic prescriptions among Veterans. Health Services Research. Epub ahead of print: August 2, 2018.