High Variability of Opioid Prescribing Within and Across Emergency Departments in the US Veterans Health Administration
Persons experiencing pain who seek treatment in emergency departments (EDs) frequently receive opioid prescriptions. These prescriptions may lead to chronic, inappropriate use of opioids and opioid-related harm.1, 2, 3 The Veterans Health Administration (VA) has implemented a nation-wide intervention promoting safe opioid prescribing, including clinician education, guidelines for prescribing opioids for chronic pain, assessing and mitigating opiate risk, and tracking clinician opiate safety practices.4 This likely contributed to fewer opioid prescriptions provided upon discharge from VA EDs, decreasing annually since 2011.5Despite this overall decline, little is known about the variability of prescribing practices among individual VA ED clinicians. The VA is a unique environment for describing clinician, facility, and regional variation in prescribing practices, given the uniform insurance benefit and national scope of care. Data on opioid prescribing variability may...
KEY WORDSopioid Veterans emergency department prescribing
This work was conducted with resources from the Veterans Health Administration’s Pharmacy Benefits Management Services, Washington, D.C., USA; the Center for Health Equity and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; and the Informatics, Decision Enhancement and Analytic Sciences Center (IDEAS2), VA Salt Lake City Health Care System, Salt Lake City, UT, USA. The supporting organizations had no role in the preparation, review, or approval of the manuscript or decision to submit the manuscript for publication.
Compliance with ethical standards
Conflict of interest
The authors declare that they do not have a conflict of interest.
The contents of this work do not represent the views of the United States Department of Veterans Affairs or the United States Government. The Veterans Health Administration’s Pharmacy Benefits Management Services approved and designated this work as a quality improvement project.
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- 6.Department of Veterans Affairs. 2012 VHA facility quality and safety report. Available at: https://www.va.gov/HEALTH/docs/2012_VHA_Facility_Quality_and_Safety_Report_FINAL508.pdf. Accessed 24 Apr 2018.