Improving access to service charities for female veterans
To date, considerations of improving access to and quality of care for veterans often emphasise male perspectives. This may not reflect the needs of female veterans, nor anticipate the needs of the increasing numbers of female service personnel as they leave service. In the work reported here we aimed to investigate public and charitable sector (service and nonservice) perspectives on the challenges and enablers female veterans face in accessing service charities, to inform and prioritise recommendations for tangible improvements in access to veteran specific services for female veterans. We achieved this aim by conducting a literature review, followed by a qualitative research study. This qualitative study comprised profiling the evolution of conditions for military service for females in UK Armed Forces, 38 stakeholder interviews, and website analysis. Findings and recommendations were discussed with an expert panel and the Project Advisory Group, and disseminated to a range of stakeholders over the course of the project. This report presents the findings of this research, discusses them in the context of previous work, and makes recommendations for service provision, policy and research.
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