Full metadata record
DC Field | Value | Language |
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dc.contributor.author | Im, Jinwoo J. | - |
dc.contributor.author | Shachter, Ross D. | - |
dc.contributor.author | Oliva, Elizabeth M. | - |
dc.contributor.author | Henderson, Patricia T. | - |
dc.contributor.author | Paik, Meenah C. | - |
dc.contributor.author | Trafton, Jodie A. | - |
dc.date.accessioned | 2018-01-25T01:10:16Z | - |
dc.date.available | 2018-01-25T01:10:16Z | - |
dc.date.created | 2017-04-10 | - |
dc.date.issued | 2015-07 | - |
dc.identifier.issn | 0884-8734 | - |
dc.identifier.uri | http://hdl.handle.net/20.500.11750/5184 | - |
dc.description.abstract | IMPORTANCE: Patients receiving opioid therapy are at elevated risk of attempting suicide. Guidelines recommend practices to mitigate risk, but it is not known whether these are effective. OBJECTIVE: Our aim was to examine associations between the receipt of guideline-recommended care for opioid therapy and risk of suicide attempt. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective analysis of administrative data for all Veteran patients prescribed any short-acting opioids on a chronic basis or any long-acting opioids from the Veterans Health Administration during fiscal year 2010. MAIN OUTCOMES AND MEASURES: Multivariate, mixed-effects logistic regression analyses were conducted to define the associations between the risk of suicide attempt and receipt of guideline-recommended care at the individual level and rates of use of recommended care at the facility level, while accounting for patient risk factors. RESULTS: At the individual level, having a mood disorder was highly associated with suicide attempts (odds ratios [ORs] = 3.5, 3.9; 95% confidence intervals [CIs] = 3.3–3.9, 3.3–4.6 for chronic short-acting and long-acting groups, respectively). At the facility level, patients on opioid therapy within the facilities ordering more drug screens were associated with decreased risk of suicide attempt (ORs = 0.2, 0.3; CIs = 0.1–0.3, 0.2–0.6 for chronic short-acting and long-acting groups, respectively). In addition, patients on long-acting opioid therapy within the facilities providing more follow-up after new prescriptions were associated with decreased risk of suicide attempt (OR = 0.2, CI = 0.0–0.7), and patients on long-acting opioid therapy within the facilities having higher sedative co-prescription rates were associated with increased risk of suicide attempt (OR = 20.3, CI = 1.1–382.2). CONCLUSIONS AND RELEVANCE: Encouraging facilities to make more consistent use of drug screening, provide follow-up within 4weeks for patients initiating new opioid prescriptions, and avoid sedative co-prescription in combination with long-acting opioids may help prevent suicide attempts. Some clinicians may selectively employ guideline-recommended practices with at-risk patients. © 2015, Society of General Internal Medicine. | - |
dc.language | English | - |
dc.publisher | SPRINGER | - |
dc.title | Association of Care Practices with Suicide Attempts in US Veterans Prescribed Opioid Medications for Chronic Pain Management | - |
dc.type | Article | - |
dc.identifier.doi | 10.1007/s11606-015-3220-y | - |
dc.identifier.scopusid | 2-s2.0-84931570065 | - |
dc.identifier.bibliographicCitation | Journal of General Internal Medicine, v.30, no.7, pp.979 - 991 | - |
dc.description.isOpenAccess | TRUE | - |
dc.subject.keywordAuthor | opioid therapy | - |
dc.subject.keywordAuthor | suicide attempt | - |
dc.subject.keywordAuthor | clinical practice guideline | - |
dc.subject.keywordPlus | Adult | - |
dc.subject.keywordPlus | Article | - |
dc.subject.keywordPlus | CHRONIC NONCANCER PAIN | - |
dc.subject.keywordPlus | Chronic Pain | - |
dc.subject.keywordPlus | Clinical Practice Guideline | - |
dc.subject.keywordPlus | Disease Association | - |
dc.subject.keywordPlus | DISORDERS | - |
dc.subject.keywordPlus | Drug Screening | - |
dc.subject.keywordPlus | Female | - |
dc.subject.keywordPlus | Follow Up | - |
dc.subject.keywordPlus | Health Care Practice | - |
dc.subject.keywordPlus | HISTORY | - |
dc.subject.keywordPlus | Human | - |
dc.subject.keywordPlus | Major Clinical Study | - |
dc.subject.keywordPlus | Male | - |
dc.subject.keywordPlus | MENTAL-HEALTH | - |
dc.subject.keywordPlus | Mood Disorder | - |
dc.subject.keywordPlus | Opiate | - |
dc.subject.keywordPlus | Opioid Therapy | - |
dc.subject.keywordPlus | OVERDOSE | - |
dc.subject.keywordPlus | Patient Risk | - |
dc.subject.keywordPlus | Practice Guideline | - |
dc.subject.keywordPlus | Prescription | - |
dc.subject.keywordPlus | PRESCRIPTION OPIOIDS | - |
dc.subject.keywordPlus | Retrospective Study | - |
dc.subject.keywordPlus | RISK | - |
dc.subject.keywordPlus | Risk Assessment | - |
dc.subject.keywordPlus | SUBSTANCE USE | - |
dc.subject.keywordPlus | Suicide Attempt | - |
dc.subject.keywordPlus | THOUGHTS | - |
dc.subject.keywordPlus | United States | - |
dc.subject.keywordPlus | Veterans Health | - |
dc.citation.endPage | 991 | - |
dc.citation.number | 7 | - |
dc.citation.startPage | 979 | - |
dc.citation.title | Journal of General Internal Medicine | - |
dc.citation.volume | 30 | - |
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