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Health Services Research & Development

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HSR&D In Progress

Summer 2016

In this Issue: Improving the Safety of Prescription Opioid Use among Veterans » Table of Contents

Safety of Opioid Use among Veterans Receiving Care in Multiple Health Systems

Ongoing Study

Almost 25% of VA patients receive opioid medications as a key component of pain management. VA has adopted several strategies to mitigate the risks of opioid-related adverse events, but these efforts focus almost entirely on monitoring prescriptions dispensed within VA. However, many Veterans have other forms of health insurance and can access healthcare and prescriptions in non-VA settings. VA cannot develop fully successful interventions to address opioid safety without understanding this non-VA care. Therefore, this ongoing HSR&D study (February 2015 - March 2018) aims to:

  • Describe patterns of opioid use from VA and non-VA sources among Veterans receiving VA healthcare;
  • Evaluate the impact of dual use of VA and non-VA opioid medications on opioid safety and opioid related serious adverse events; and
  • Explore provider and other stakeholder perspectives on identifying and managing dual use of opioid medications in Veterans.

To accomplish these aims, investigators will analyze both VA and non-VA data to track medication use and healthcare utilization for all Veterans receiving an opioid medication. Investigators also will conduct semi-structured interviews with key stakeholders, exploring providers' perceptions of dual use of opioid medications, and the views of stakeholder leaders within and outside VA. This information will help investigators interpret and synthesize valuable information about dual use of opioid medications.


The long-term goal of this research is to ensure the safe and appropriate use of opioids by Veterans, which is a major strategic goal for VA. By examining the extent of dual opioid use, the influences on dual use, and the effects of dual use on safety, VA can design more effective policies and interventions to ensure the safe use of opioids for pain management in Veterans.

Radomski T, Zhao X, Thorpe C, et al. VA and Medicare utilization among dually-enrolled Veterans with type 2 diabetes: A latent class analysis. Journal of General Internal Medicine. May 2016; 31(5):524-31.

View study abstract

Principal Investigator: Walid Gellad, MD, MPH, is part of HSR&D's Center for Health Equity Research & Promotion (CHERP) in Pittsburgh and Philadelphia, PA.

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