Abstract: This UK Armed Forces Families Strategy 2022-32 has a dual focus: to inspire partnership working across the UK, honouring the enduring pledge of the Armed Forces Covenant; and to provide direction to policy makers, the single Services and public service providers to empower armed forces families to live rich and fulfilling lives alongside their loved ones. As such, the strategy provides both the context and the framework for the delivery of a range of practical interventions designed to strengthen and improve policies and service provision across the armed forces families agenda, leading to improved retention and enhanced operational effectiveness. Measuring success will be critical and will be achieved through the monitoring of progress under the supporting action plan.
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