The Armed Forces Covenant and Veterans Annual Report 2021
Abstract: This is the 10th Armed Forces Covenant Annual Report since its introduction as a statutory requirement in the Armed Forces Act 2011. It is also the first wholly joint and integrated report between the Ministry of Defence (MOD) and the Office for Veterans’ Affairs (OVA) in the Cabinet Office. This year’s report has therefore been retitled as the Armed Forces Covenant and Veterans Annual Report. It covers the period 1 October 2020 to 30 September 2021, and it is the Government’s annual update to Parliament on delivery against both the Covenant (as it applies to Service personnel, veterans, their families and those who are bereaved) and the Strategy for our Veterans. The report covers actions that the UK Government and the Devolved Administrations have taken during the reporting period to deliver the Covenant and the Strategy across the UK – in England, Scotland, Wales and Northern Ireland.
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