Strategy for our Veterans, 6 monthly Report, August 2023
Abstract: The Strategy for our Veterans sets out the Government’s 10 year vision for veterans and their families to transition into civilian life and contribute fully to a society that understands and values what they have to offer. While it is a UK-wide document, delivery looks different in each of the devolved nations and as such, information on progress being made in Scotland, Wales and Northern Ireland can be found via their respective websites. For England, the OVA has committed to publishing a series of action plans to support progress against the 2028 objectives, alongside being responsive to emerging issues and opportunities.
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