Impact of Dual Use of Department of Veterans Affairs and Medicare Part D Drug Benefits on Potentially Unsafe Opioid Use. Journal Article

Local Library Link: Find It @ Loyola

Authors: Gellad, WF; Thorpe, JM; Zhao, X; Thorpe, CT; Sileanu, FE; Cashy, JP; Hale, JA; Mor, MK; Radomski, TR; Hausmann, LRM; Donohue, JM; Gordon, AJ; Suda, KJ; Stroupe, KT; Hanlon, JT; Cunningham, FE; Good, CB; Fine, MJ
Article Title: Impact of Dual Use of Department of Veterans Affairs and Medicare Part D Drug Benefits on Potentially Unsafe Opioid Use.
Abstract: OBJECTIVES: To estimate the prevalence and consequences of receiving prescription opioids from both the Department of Veterans Affairs (VA) and Medicare Part D. METHODS: Among US veterans enrolled in both VA and Part D filling 1 or more opioid prescriptions in 2012 (n?=?539?473), we calculated 3 opioid safety measures using morphine milligram equivalents (MME): (1) proportion receiving greater than 100 MME for 1 or more days, (2) mean days receiving greater than 100 MME, and (3) proportion receiving greater than 120 MME for 90 consecutive days. We compared these measures by opioid source. RESULTS: Overall, 135?643 (25.1%) veterans received opioids from VA only, 332?630 (61.7%) from Part D only, and 71?200 (13.2%) from both. The dual-use group was more likely than the VA-only group to receive greater than 100 MME for 1 or more days (34.3% vs 10.9%; adjusted risk ratio [ARR]?=?3.0; 95% confidence interval [CI]?=?2.9, 3.1), have more days with greater than 100 MME (42.5 vs 16.9 days; adjusted difference?=?16.4 days; 95% CI?=?15.7, 17.2), and to receive greater than 120 MME for 90 consecutive days (7.8% vs 3.1%; ARR?=?2.2; 95% CI?=?2.1, 2.3). CONCLUSIONS: Among veterans dually enrolled in VA and Medicare Part D, dual use of opioids was associated with more than 2 to 3 times the risk of high-dose opioid exposure.
Journal Title: American Journal of Public Health
ISSN: 0090-0036
Publisher: Unknown  
Date Published: 2018