Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care.

Autor:	Lisi AJ; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Corcoran KL; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., DeRycke EC; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut., Bastian LA; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Becker WC; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Edmond SN; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Goertz CM; The Spine Institute for Quality, Davenport, Iowa., Goulet JL; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Haskell SG; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Higgins DM; VA Boston Healthcare System, Boston, Massachusetts.; School of Medicine, Boston University, Boston, Massachusetts., Kawecki T; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Kerns RD; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Mattocks K; VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts.; University of Massachusetts Medical School, Worcester, Massachusetts, USA., Ramsey C; Yale School of Medicine, Yale University, New Haven, Connecticut., Ruser CB; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut., Brandt CA; Pain Research, Informatics, Multimorbidities and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, Connecticut.; Yale School of Medicine, Yale University, New Haven, Connecticut.
Jazyk:	angličtina
Zdroj:	Pain medicine (Malden, Mass.) [Pain Med] 2018 Sep 01; Vol. 19 (suppl_1), pp. S54-S60.
DOI:	10.1093/pm/pny114
Abstrakt:	Objective: To examine patient sociodemographic and clinical characteristics associated with opioid use among Veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who receive chiropractic care, and to explore the relationship between timing of a chiropractic visit and receipt of an opioid prescription. Methods: Cross-sectional analysis of administrative data on OEF/OIF/OND veterans who had at least one visit to a Veterans Affairs (VA) chiropractic clinic between 2004 and 2014. Opioid receipt was defined as at least one prescription within a window of 90 days before to 90 days after the index chiropractic clinic visit. Results: We identified 14,025 OEF/OIF/OND veterans with at least one chiropractic visit, and 4,396 (31.3%) of them also received one or more opioid prescriptions. Moderate/severe pain (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.72-2.03), PTSD (OR = 1.55, 95% CI = 1.41-1.69), depression (OR = 1.40, 95% CI = 1.29-1.53), and current smoking (OR = 1.39, 95% CI = 1.26-1.52) were associated with a higher likelihood of receiving an opioid prescription. The percentage of veterans receiving opioid prescriptions was lower in each of the three 30-day time frames assessed after the index chiropractic visit than before. Conclusions: Nearly one-third of OEF/OIF/OND veterans receiving VA chiropractic services also received an opioid prescription, yet the frequency of opioid prescriptions was lower after the index chiropractic visit than before. Further study is warranted to assess the relationship between opioid use and chiropractic care.
Databáze:	MEDLINE
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