Patience Moyo1, Xinhua Zhao2, Carolyn T Thorpe3, Joshua M Thorpe3, Florentina E Sileanu2, John P Cashy2, Jennifer A Hale2, Maria K Mor4, Thomas R Radomski5, Julie M Donohue6, Leslie R M Hausmann7, Joseph T Hanlon8, Chester B Good9, Michael J Fine7, Walid F Gellad10. 1. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh Health Policy Institute, Pittsburgh, PA, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA. 2. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. 3. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh Health Policy Institute, Pittsburgh, PA, USA; Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA. 4. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 5. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh Health Policy Institute, Pittsburgh, PA, USA; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 6. Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh Health Policy Institute, Pittsburgh, PA, USA; Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 7. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 8. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh Health Policy Institute, Pittsburgh, PA, USA; Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA; Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 9. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh Health Policy Institute, Pittsburgh, PA, USA; Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA; Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Center for Value Based Pharmaceutical Initiatives, UPMC Health Plan, Pittsburgh, PA, USA. 10. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh Health Policy Institute, Pittsburgh, PA, USA; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: walid.gellad@va.gov.
Abstract
BACKGROUND: Few studies have assessed prescription opioid supply preceding death in individuals dying from unintentional prescription opioid overdoses, or described the characteristics of these individuals, particularly among Veterans. OBJECTIVES: To describe the history of prescription opioid supply preceding prescription opioid overdose death among Veterans. METHODS: In a national cohort of Veterans who filled ≥1 opioid prescriptions from the Veterans Health Administration (VA) or Medicare Part D during 2008-2013, we identified deaths from unintentional or undetermined-intent prescription opioid overdoses in 2012-2013. We captured opioid prescriptions using both linked VA and Part D data, and VA data only. RESULTS: Among 1181 decedents, 643 (54.4%) had prescription opioid supply on the day of death, and 735 (62.2%) within 30 days based on linked data, compared to 40.1% and 46.7%, respectively, using VA data alone. Decedents with prescription opioid supply were significantly older and less likely to have alcohol or illicit drugs as co-occurring substances involved in the overdose. Using linked data, 241 (20.4%) decedents lacked prescription opioid supply within a year of death. CONCLUSIONS: Many VA patients who die from prescription opioid overdose receive opioid prescriptions outside VA or not at all. It is important to supplement VA with non-VA data to more accurately measure prescription opioid exposure and improve opioid medication safety. Published by Elsevier Inc.
BACKGROUND: Few studies have assessed prescription opioid supply preceding death in individuals dying from unintentional prescription opioid overdoses, or described the characteristics of these individuals, particularly among Veterans. OBJECTIVES: To describe the history of prescription opioid supply preceding prescription opioid overdose death among Veterans. METHODS: In a national cohort of Veterans who filled ≥1 opioid prescriptions from the Veterans Health Administration (VA) or Medicare Part D during 2008-2013, we identified deaths from unintentional or undetermined-intent prescription opioid overdoses in 2012-2013. We captured opioid prescriptions using both linked VA and Part D data, and VA data only. RESULTS: Among 1181 decedents, 643 (54.4%) had prescription opioid supply on the day of death, and 735 (62.2%) within 30 days based on linked data, compared to 40.1% and 46.7%, respectively, using VA data alone. Decedents with prescription opioid supply were significantly older and less likely to have alcohol or illicit drugs as co-occurring substances involved in the overdose. Using linked data, 241 (20.4%) decedents lacked prescription opioid supply within a year of death. CONCLUSIONS: Many VA patients who die from prescription opioid overdose receive opioid prescriptions outside VA or not at all. It is important to supplement VA with non-VA data to more accurately measure prescription opioid exposure and improve opioid medication safety. Published by Elsevier Inc.
Entities:
Keywords:
Drug overdose; Medicare Part D; Poisoning deaths; Prescription opioids; Veterans
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