{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T14:50:52Z","timestamp":1766587852277,"version":"build-2065373602"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pain assessment and management of Veterans with Alzheimer's disease and Related Dementia (ADRD) living in Community Living Centers (CLCs) is challenging. Safe and effective use of opioids in the treatment of pain is of great concern to patients and providers promulgating national policies and guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study examined long\u2010stay CLC Veterans with ADRD identified in three regulatory periods (period 1: 10\/2012\u20136\/2013,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u20093347; period 2: 1\/2014\u201311\/2015,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u20094426; period 3: 1\/2017\u20139\/2018,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u20094444; Total\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0= 12,217).This population\u2010based observational study used CLC Minimum Data Set (MDS) data in Fiscal Years (FYs) 2013\u20132018 and VA bar\u2010code medication administration (BCMA) data. Opioid administration measures included: any opioids, long\u2010term opioids, high\u2010dose opioids, and co\u2010administration with benzodiazepine. Measures were modeled using negative binomial regression with length of stay in CLC as offset adjusting for Veteran predisposing, enabling and need measures from the MDS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to period 1, any opioid administration was 26% lower in period 2, and 34% lower in period 3. Among Veterans who received any opioid medications over the three regulatory periods, high\u2010dose and long\u2010term opioid administration were more than 40% lower in periods 2 and 3 compared to period 1. Co\u2010administration of opioid with benzodiazepine versus no opioid was 11% lower in period 2 and 34% lower in period 3 after adjusting for patient level covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All patterns of opioid administration decreased over the four opioid regulations periods when guidelines were promulgated across the VA health system. Further research should clarify whether decreasing opioids among patients with ADRD impacted health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17785","type":"journal-article","created":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T11:15:56Z","timestamp":1649502956000},"page":"2393-2403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Opioid administration trends among long\u2010stay community living centers residents with dementia"],"prefix":"10.1111","volume":"70","author":[{"given":"Huiying","family":"Wang","sequence":"first","affiliation":[{"name":"Geriatrics and Extended Care Data and Analysis Center (GECDAC) Finger Lakes Healthcare System  Canandaigua New York USA"},{"name":"Public Health Sciences University of Rochester  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shubing","family":"Cai","sequence":"additional","affiliation":[{"name":"Geriatrics and Extended Care Data and Analysis Center (GECDAC) Finger Lakes Healthcare System  Canandaigua New York USA"},{"name":"Public Health Sciences University of Rochester  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Caprio","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Goulet","sequence":"additional","affiliation":[{"name":"VA Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Department of Emergency Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orna","family":"Intrator","sequence":"additional","affiliation":[{"name":"Geriatrics and Extended Care Data and Analysis Center (GECDAC) Finger Lakes Healthcare System  Canandaigua New York USA"},{"name":"Public Health Sciences University of Rochester  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_11_2_1","DOI":"10.1016\/S0140-6736(99)03528-X"},{"doi-asserted-by":"publisher","key":"e_1_2_11_3_1","DOI":"10.15585\/mmwr.mm6626a4"},{"doi-asserted-by":"publisher","key":"e_1_2_11_4_1","DOI":"10.1016\/j.jpain.2016.10.021"},{"doi-asserted-by":"publisher","key":"e_1_2_11_5_1","DOI":"10.2147\/SAR.S116720"},{"doi-asserted-by":"publisher","key":"e_1_2_11_6_1","DOI":"10.1097\/MLR.0b013e318202aa27"},{"doi-asserted-by":"publisher","key":"e_1_2_11_7_1","DOI":"10.1001\/jama.2017.0935"},{"unstructured":"Pain as the 5Th Vital Sign Toolkit.Department of Veteran Affairs. 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