{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:23:24Z","timestamp":1740126204360,"version":"3.37.3"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Health Services Research Program"},{"name":"United States Defense Health Agency","award":["# HU0001-20-2-0035"],"award-info":[{"award-number":["# HU0001-20-2-0035"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Opioid misuse is a nationwide issue and is of particular concern with regard to military readiness. The 2017 National Defense Authorization Act charges the Military Health System with greater oversight of opioid use and mitigation of misuse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We synthesized published articles using secondary analysis of TRICARE claims data, a nationally representative database of 9.6 million beneficiaries. We screened 106 articles for inclusion and identified 17 studies for data abstraction. Framework analysis was conducted, which assessed prescribing practices, patient use, and optimum length of opioid prescriptions after surgery, trauma, and common procedures, as well as factors leading to sustained prescription opioid use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Across the studies, sustained prescription opioid use after surgery was low overall, with &amp;lt;1% of opioid-na\u00efve patients still receiving opioids more than 1\u2009year after spinal surgery or trauma. In opioid-exposed patients who had undergone spine surgery, sustained use was slightly lower than 10%. Higher rates of sustained use were associated with more severe trauma and depression, as well as with prior use and initial opioid prescriptions for low back pain or other undefined conditions. Black patients were more likely to discontinue opioid use than were White patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Prescribing practices are well correlated with degree of injury or intensity of intervention. Sustained prescription opioid use beyond 1\u2009year is rare and is associated with diagnoses for which opioids are not the standard of care. More efficient coding, increased attention to clinical practice guidelines, and use of tools to predict risk of sustained prescription opioid use are recommended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnad072","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T13:56:54Z","timestamp":1686319014000},"page":"1133-1137","source":"Crossref","is-referenced-by-count":1,"title":["Opioid prescribing and use in the Military Health System: a framework synthesis, FY2016\u2013FY2021"],"prefix":"10.1093","volume":"24","author":[{"given":"Cathaleen","family":"Madsen","sequence":"first","affiliation":[{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc ., Bethesda, MD 20817, United States"},{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-5171","authenticated-orcid":false,"given":"Jessica","family":"Korona-Bailey","sequence":"additional","affiliation":[{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc ., Bethesda, MD 20817, United States"},{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda Lynn","family":"Janvrin","sequence":"additional","affiliation":[{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc ., Bethesda, MD 20817, United States"},{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Schoenfeld","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health, Department of Orthopaedic Surgery, Harvard Medical School, Brigham & Women\u2019s Hospital , Boston, MA 02115, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey P\u00e9rez","family":"Koehlmoos","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences , Bethesda, MD 20814, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"author":"National Center for Health 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