{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:32:33Z","timestamp":1777923153204,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007181","name":"Quality Enhancement Research Initiative","doi-asserted-by":"publisher","award":["PEC 16- 001"],"award-info":[{"award-number":["PEC 16- 001"]}],"id":[{"id":"10.13039\/100007181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["SDR 19-326"],"award-info":[{"award-number":["SDR 19-326"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although long-term opioid therapy (LTOT) has its own risks, opioid discontinuation could pose harm for high-risk Veterans Health Administration (VHA) patients receiving LTOT. There is limited information on the impact of a mandate requiring providers to perform case reviews on high-risk patients with an active opioid prescription (ie, mandated case review policy) on opioid discontinuation and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Our study is a secondary data analysis of a 23-month stepped-wedge cluster randomized controlled trial between April 2018 and March 2020. The study included 10\u2009685 LTOT patients with a predicted risk of a serious adverse event between the top 1% to 5% nationally who entered the risk range between 4\/18\/2018 and 11\/9\/2019. We examined whether the mandated case review policy had an impact on opioid discontinuation and mortality for the patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 10\u2009685 LTOT patients (88.2% male; mean [SD] age, 61.1 [11.7] years), 29.1% experienced discontinuation and the mortality rate was 9.5%. Patients under mandated case review had a decreased risk of opioid discontinuation (average marginal effect [AME], \u221211.16 [95% CI, \u221215.30 to \u22127.01] percentage points) and all-cause mortality (AME, \u22123.31 [95% CI, \u22125.63 to \u22121.00] percentage points), relative to patients who were not under the mandate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The VHA mandated case review policy was associated with lower probability of discontinuation and all-cause mortality for high-risk patients receiving LTOT. Interventions that maintain care engagement while optimizing pain management for high-risk patients may be beneficial for minimizing mortality and other risks associated with discontinuation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08897077231198299","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T07:58:03Z","timestamp":1697183883000},"page":"292-300","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Mandated Case Review Policy on Opioid Discontinuation and Mortality Among High-Risk Long-Term Opioid Therapy Patients: The STORM Stepped-Wedge Cluster Randomized Controlled Trial"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5940-4606","authenticated-orcid":false,"given":"Yufei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Health Law, Policy and Management, Boston University of Public Health, Boston, MA, USA"},{"name":"Partnered Evidence-based Policy Resource Center, VA Boston Healthcare System, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle D.","family":"Barr","sequence":"additional","affiliation":[{"name":"Partnered Evidence-based Policy Resource Center, VA Boston Healthcare System, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodie A.","family":"Trafton","sequence":"additional","affiliation":[{"name":"Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, Veterans Health Administration, Menlo Park, CA, USA"},{"name":"Center for Innovation to Implementation, VA Palo Alto Health Care System, Veterans Health Administration, Menlo Park, CA, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, Stanford University Medical School, Palo Alto, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth M.","family":"Oliva","sequence":"additional","affiliation":[{"name":"Program Evaluation and Resource Center, Office of Mental Health and Suicide Prevention, Veterans Health Administration, Menlo Park, CA, USA"},{"name":"Center for Innovation to Implementation, VA Palo Alto Health Care System, Veterans Health Administration, Menlo Park, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa M.","family":"Garrido","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy and Management, Boston University of Public Health, Boston, MA, USA"},{"name":"Partnered Evidence-based Policy Resource Center, VA Boston Healthcare System, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Austin B.","family":"Frakt","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy and Management, Boston University of Public Health, Boston, MA, USA"},{"name":"Partnered Evidence-based Policy Resource Center, VA Boston Healthcare System, Boston, MA, USA"},{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiersten L.","family":"Strombotne","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy and Management, Boston University of Public Health, Boston, MA, USA"},{"name":"Partnered Evidence-based Policy Resource Center, VA Boston Healthcare System, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"bibr1-08897077231198299","unstructured":"Overdose Death Rates\n                      . National Institute on Drug Abuse; 2021. 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