• Health services research · Dec 2018

    Linkage of VA and State Prescription Drug Monitoring Program Data to Examine Concurrent Opioid and Sedative-Hypnotic Prescriptions among Veterans.

    • Kathleen F Carlson, Tess A Gilbert, Benjamin J Morasco, Dagan Wright, Otterloo Joshua Van JV Prescription Drug Monitoring Program, Public Health Division, Oregon Health Authority, Portland, OR., Aldona Herrndorf, and Lawrence J Cook.
    • HSR&D Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR.
    • Health Serv Res. 2018 Dec 1; 53 Suppl 3: 5285-5308.

    ObjectiveTo examine the prevalence of concurrent Veterans Health Administration (VA) and non-VA prescriptions for opioids and sedative-hypnotic medications among post-9/11 veterans in Oregon.Data SourcesVA health care and prescription data were probabilistically linked with Oregon Prescription Drug Monitoring Program (PDMP) data.Study DesignThis retrospective cohort study examined concurrent prescriptions among n = 19,959 post-9/11 veterans, by year (2014-2016) and by patient demographic and clinical characteristics. Veterans were included in the cohort for years in which they received VA outpatient care; those receiving hospice or palliative care were excluded. Concurrent prescriptions were defined as ≥1 days of overlap between outpatient prescriptions for opioids and/or sedative-hypnotics (categorized as benzodiazepines vs. non-benzodiazepines).Principal FindingsAmong 5,882 veterans who filled opioid or sedative-hypnotic prescriptions at VA pharmacies, 1,036 (17.6 percent) filled concurrent prescriptions from non-VA pharmacies. Within drug class, 15.1, 8.8, and 4.6 percent received concurrent VA and non-VA opioids, benzodiazepines, and non-benzodiazepines, respectively. Veteran demographics and clinical diagnoses were associated with the likelihood of concurrent prescriptions, as was enrollment in the Veterans Choice Program.ConclusionsA considerable proportion of post-9/11 veterans receiving VA care in Oregon filled concurrent prescriptions for opioids and sedative-hypnotics. Fragmentation of care may contribute to prescription drug overdose risk among veterans.© Health Research and Educational Trust.

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