Annual Medical Discharges in the UK Regular Armed Forces (1 April 2011 - 31 March 2016)
Abstract: This bulletin has been published to provide both the Ministry of Defence (MOD) and the general public with information on the number and rate of personnel that leave the Service as a result of a medical discharge and the causes behind these discharges. It has been produced in response to the increased public interest in medical discharges from the UK Armed Forces. In addition this information is used to prioritise resources used for the rehabilitation and reintegration of personnel leaving the Armed Forces or medical reasons and to help inform discussions on injury prevention in the Armed Forces.
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