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.
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Res Social Adm Pharm. 2019 Aug;15(8):1007-1013. doi: 10.1016/j.sapharm.2018.10.023. Epub 2018 Oct 17.
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.
To describe the history of prescription opioid supply preceding prescription opioid overdose death among Veterans.
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.
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.
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.
鲜有研究评估过在非故意过量服用处方类阿片药物而死亡的人群中，其生前处方类阿片药物供应情况，或描述这些人群的特征，尤其是退伍军人。
描述退伍军人因过量服用处方类阿片药物而死亡前的处方类阿片药物供应情况。
在一个退伍军人队列中，这些退伍军人在 2008 年至 2013 年期间通过退伍军人事务部（VA）或医疗保险部分 D 领取了至少一份阿片类药物处方，我们确定了 2012 年至 2013 年期间非故意或原因不明的处方类阿片药物过量死亡病例。我们使用退伍军人事务部和医疗保险部分 D 的相关数据以及退伍军人事务部的数据分别获取阿片类药物处方情况。
在 1181 名死者中，643 人（54.4%）在死亡当天有处方类阿片药物供应，根据相关数据，735 人（62.2%）在死亡前 30 天内有处方类阿片药物供应，而仅使用退伍军人事务部数据时，这一比例分别为 40.1%和 46.7%。有处方类阿片药物供应的死者年龄明显更大，且同时滥用酒精或非法药物的可能性较小。根据相关数据，241 名死者（20.4%）在死亡前一年内没有处方类阿片药物供应。
许多因过量服用处方类阿片药物而死亡的退伍军人在退伍军人事务部以外或根本没有接受过阿片类药物治疗。通过退伍军人事务部以外的数据来补充退伍军人事务部的数据，对于更准确地测量处方类阿片类药物的暴露情况和改善阿片类药物的安全性非常重要。
