Opioid Prescribing Trends in the Veterans Health Administration

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Reductions in long-term opioid prescribing from 2010 to 2016 accounted for 83% of the overall decline in opioid prescription fills.
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."

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Reference

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

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