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Translational Behavioral Medicine
Published in: Translational Behavioral Medicine 4/2016

01-12-2016 | Original Research

Healthcare system-wide implementation of opioid-safety guideline recommendations: the case of urine drug screening and opioid-patient suicide- and overdose-related events in the Veterans Health Administration

Authors: Penny L. Brennan, Ph.D., Aaron C. Del Re, Ph.D., Patricia T. Henderson, M.S., Jodie A. Trafton, Ph.D.

Published in: Translational Behavioral Medicine | Issue 4/2016

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Abstract

This study provides an example of how healthcare system-wide progress in implementation of opioid-therapy guideline recommendations can be longitudinally assessed and then related to subsequent opioid-prescribed patient health and safety outcomes. Using longitudinal linear mixed effects analyses, we determined that in the Department of Veterans Affairs (VA) healthcare system (n = 141 facilities), over the 4-year interval from 2010 to 2013, a key opioid therapy guideline recommendation, urine drug screening (UDS), increased from 29 to 42 %, with an average within-facility increase rate of 4.5 % per year. Higher levels of UDS implementation from 2010 to 2013 were associated with lower risk of suicide and drug overdose events among VA opioid-prescribed patients in 2013, even after adjusting for patients’ 2012 demographic characteristics and medical and mental health comorbidities. Findings suggest that VA clinicians and healthcare policymakers have been responsive to the 2010 VA/Department of Defense (DOD) UDS treatment guideline recommendation, resulting in improved patient safety for VA opioid-prescribed patients.
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Metadata
Title
Healthcare system-wide implementation of opioid-safety guideline recommendations: the case of urine drug screening and opioid-patient suicide- and overdose-related events in the Veterans Health Administration
Authors
Penny L. Brennan, Ph.D.
Aaron C. Del Re, Ph.D.
Patricia T. Henderson, M.S.
Jodie A. Trafton, Ph.D.
Publication date
01-12-2016
Publisher
Springer US
Published in
Translational Behavioral Medicine / Issue 4/2016
Print ISSN: 1869-6716
Electronic ISSN: 1613-9860
DOI
https://doi.org/10.1007/s13142-016-0423-7

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