Opioid Prescribing Trends in the Veterans Health Administration
Reductions in long-term opioid prescribing from 2010 to 2016 accounted for 83% of the overall decline in opioid prescription fills.
HealthDay News — Opioid prescribing trends in the Veterans Health Administration (VHA) from 2010 to 2016 followed similar trajectories as non-VHA settings, peaking around 2012 then declining, according to a study published online in the Journal of General Internal Medicine.
Katherine Hadlandsmyth, PhD, from the Iowa City VA Healthcare System, and colleagues assessed the prevalence of short- and long-term opioid prescribing in the VHA from 2010 to 2016 in an observational, cohort study.
The researchers grouped duration of use into 3 categories (short-term, intermediate-term, and long-term) and analyzed prescription data from VHA databases.
The researchers found that the prevalence of opioid prescribing was 20.8% in 2010, rose to 21.2% in 2012, and declined annually to 16.1% in 2016. Reductions in long-term opioid prescribing from 2010 to 2016 accounted for 83% of the overall decline in opioid prescription fills.
Increases in cessation among existing long-term users accounted for less than 10% of the decreasing prevalence of long-term opioid use over the study period. Compared to patients with no opioid prescriptions filled during 2015, the relative risk of transitioning to long-term use during 2016 was 6.5 for short-term users and 35.5 for intermediate users.
"Recent VA opioid initiatives may be preventing patients from initiating long-term use," the authors write. "This may offer valuable lessons generalizable to other health care systems."
Hadlandsmyth K, Mosher H, Vander Weg MW, Lund BC. Decline in prescription opioids attributable to decreases in long-term use: a retrospective study in the Veterans Health Administration 2010-2016 [published online January 29, 2018]. J Gen Intern Med. doi: 10.1007/s11606-017-4283-8