Healthcare Inspection: VA Patterns of Dispensing Take-Home Opioids and Monitoring Patients on Opioid Therapy.

摘要

As requested by the United States Senate Committee on Veterans Affairs, the VA Office of Inspector General conducted a study to assess the provision of VA outpatient (take-home) opioids and monitoring of patients on opioid therapy (hereinafter referred to as opioid patients). Specifically, we described both the prevalence of VA patients who filled any take-home opioid prescriptions at VA in fiscal year (FY) 2012 and their baseline characteristics; evaluated VA dispensing patterns of take-home opioids, including concurrent (filled) benzodiazepines, filled dose of acetaminophen, and early refills of opioids; and assessed the extent to which VA screens and monitors opioid patients in alignment with measures adapted from selected recommendations in the VA/Department of Defense Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain (hereinafter referred to as the Clinical Practice Guideline). We also defined VA patterns of providing psychosocial treatment for pain, Pain Clinic service, and medication management/pharmacy reconciliation for take-home opioid patients and determined the prevalence of six selected serious clinical adverse effects among VA take-home opioid patients that may be reasonably expected to be related to opioid therapy.