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Prescriptions Written for Opioid Pain Medication in the Veterans Health Administration Between 2000 and 2016.
J Addict Med. 2017 Nov/Dec; 11(6):483-488.JA

Abstract

OBJECTIVES

The purpose of this study was to identify national opioid pain medication (OPM) prescribing trends within the Veterans Health Administration (VA), and assess the impact of educational campaigns introduced in 2010 and 2013.

METHODS

We created a national cohort that documents more than 21 million patient records and 97 million outpatient OPM prescriptions covering a 17-year period. We examined OPM prescriptions in emergency departments, outpatient clinics, and inpatient settings.

RESULTS

The cohort accounted for 2.5 billion outpatient clinic visits, 18.9 million emergency department visits, and 12.4 million hospital admissions. The number of OPM prescriptions peaked in 2011, when they were provided during 5% of all outpatient visits and 15% of all emergency department visits. The morphine milligram equivalents (MMEs) peaked in 2014 at almost 17 billion in outpatient clinics and at 137 million in emergency departments. In 2016, OPM prescriptions were down 37% in outpatient clinics and 23% in emergency departments, and MMEs were down 30% in both settings. Prescriptions for hydrocodone and tramadol increased markedly between 2011 and 2015. OPM doses in inpatient settings continued to rise until 2015.

CONCLUSIONS

We used a large national cohort to study trends in OPM prescriptions within the VA. Educational efforts to reduce the number of OPM prescriptions coincided with these reductions, but were initially associated with an increase in OPM dosage, an increase in the use of tramadol and hydrocodone, and an increase in the use of OPMs in inpatient settings.

Authors+Show Affiliations

University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, MD (MAG); University of Maryland Baltimore County, Department of Computer Science and Electrical Engineering, Baltimore, MD (CTG); University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, MD (DAJ).No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28858889

Citation

Grasso, Michael A., et al. "Prescriptions Written for Opioid Pain Medication in the Veterans Health Administration Between 2000 and 2016." Journal of Addiction Medicine, vol. 11, no. 6, 2017, pp. 483-488.
Grasso MA, Grasso CT, Jerrard DA. Prescriptions Written for Opioid Pain Medication in the Veterans Health Administration Between 2000 and 2016. J Addict Med. 2017;11(6):483-488.
Grasso, M. A., Grasso, C. T., & Jerrard, D. A. (2017). Prescriptions Written for Opioid Pain Medication in the Veterans Health Administration Between 2000 and 2016. Journal of Addiction Medicine, 11(6), 483-488. https://doi.org/10.1097/ADM.0000000000000352
Grasso MA, Grasso CT, Jerrard DA. Prescriptions Written for Opioid Pain Medication in the Veterans Health Administration Between 2000 and 2016. J Addict Med. 2017 Nov/Dec;11(6):483-488. PubMed PMID: 28858889.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prescriptions Written for Opioid Pain Medication in the Veterans Health Administration Between 2000 and 2016. AU - Grasso,Michael A, AU - Grasso,Clare T, AU - Jerrard,David A, PY - 2017/9/1/pubmed PY - 2018/6/16/medline PY - 2017/9/1/entrez SP - 483 EP - 488 JF - Journal of addiction medicine JO - J Addict Med VL - 11 IS - 6 N2 - OBJECTIVES: The purpose of this study was to identify national opioid pain medication (OPM) prescribing trends within the Veterans Health Administration (VA), and assess the impact of educational campaigns introduced in 2010 and 2013. METHODS: We created a national cohort that documents more than 21 million patient records and 97 million outpatient OPM prescriptions covering a 17-year period. We examined OPM prescriptions in emergency departments, outpatient clinics, and inpatient settings. RESULTS: The cohort accounted for 2.5 billion outpatient clinic visits, 18.9 million emergency department visits, and 12.4 million hospital admissions. The number of OPM prescriptions peaked in 2011, when they were provided during 5% of all outpatient visits and 15% of all emergency department visits. The morphine milligram equivalents (MMEs) peaked in 2014 at almost 17 billion in outpatient clinics and at 137 million in emergency departments. In 2016, OPM prescriptions were down 37% in outpatient clinics and 23% in emergency departments, and MMEs were down 30% in both settings. Prescriptions for hydrocodone and tramadol increased markedly between 2011 and 2015. OPM doses in inpatient settings continued to rise until 2015. CONCLUSIONS: We used a large national cohort to study trends in OPM prescriptions within the VA. Educational efforts to reduce the number of OPM prescriptions coincided with these reductions, but were initially associated with an increase in OPM dosage, an increase in the use of tramadol and hydrocodone, and an increase in the use of OPMs in inpatient settings. SN - 1935-3227 UR - https://www.unboundmedicine.com/medline/citation/28858889/Prescriptions_Written_for_Opioid_Pain_Medication_in_the_Veterans_Health_Administration_Between_2000_and_2016_ L2 - https://doi.org/10.1097/ADM.0000000000000352 DB - PRIME DP - Unbound Medicine ER -