Outpatient provider contact prior to unintentional opioid overdose

Details

• Alternative Title:
  Psychiatr Serv
• Personal Author:
  Lin, Lewei (Allison) ; Bohnert, Amy ; Ilgen, Mark ; Pfeiffer, Paul Nelson ; Ganoczy, Dara ; Blow, Fred
• Description:
  Objectives
  
  Prescribed opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to overdose.
  
  Methods
  
  This study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004–2007 and used VHA services anytime within two years of their deaths (n=1,813). For those whose last treatment contact was in an outpatient setting (n=1,457), demographic, clinical and treatment characteristics were compared among patients categorized by the location of their last contact.
  
  Results
  
  33% (N=479) of those last seen in outpatient settings were seen within one week and 62% (N=910) within one month of their overdose. A substantial proportion of patients were last seen within one month of death in mental health or substance disorder outpatient settings (30% N=438). The majority of patients did not fill an opioid prescription on their last outpatient visit prior to unintentional opioid overdose.
  
  Conclusions
  
  The majority of patients who died by unintentional overdose on prescription opioids were seen within a month of their overdose in outpatient settings. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses, and interventions to reduce risk should not be limited to visits that resulted in an opioid prescription.
  
  
• Subjects:
  Adolescent Adult Aged Ambulatory Care Analgesics, Opioid Article Cause Of Death Databases, Factual Drug Overdose Drug Prescriptions Female Humans Male Middle Aged Outpatients Risk Factors Time Factors Veterans Veterans Health Young Adult

  More +
• Source:
  Psychiatr Serv. 66(11):1149-1154
• Pubmed ID:
  26129993
• Pubmed Central ID:
  PMC4630148
• Document Type:
  Journal Article
• Funding:
  CDA 09-204/HX/HSRD VA/United States ; R03 AG042899/AG/NIA NIH HHS/United States ; U01 CE002780/CE/NCIPC CDC HHS/United States
• Volume:
  66
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:64a9c056a4d12efbd5dbf59596e0905dfb9c0d89ca31f28f91d3c849332c4634
• Download URL:
  https://stacks.cdc.gov/view/cdc/101056/cdc_101056_DS1.pdf
• File Type:
  [PDF - 340.76 KB ]