King’s Centre for Military Health Research: A fifteen year report
This report presents a comprehensive overview of the findings from the King's Centre for Military Health Research (KCMHR) research on the UK Armed Forces' health, which has been ongoing for 15 years. The study examines the health and well-being of UK Armed Forces personnel, focusing on the impact of military service, including deployment to conflict zones such as Iraq and Afghanistan. Key areas of investigation include mental health outcomes, physical health, and the social and occupational functioning of service members. The report highlights significant issues such as the prevalence of post-traumatic stress disorder (PTSD), depression, alcohol misuse, and the challenges faced during the transition to civilian life. The findings underscore the importance of continued support and targeted interventions to address the health needs of military personnel and veterans. The study provides valuable insights into the long-term effects of military service, informing policy and practice aimed at improving the health and well-being of those who serve.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P