Category: Federal Forum Posters
Purpose: In 2016, a large study evaluated the prevalence and risks associated with central nervous system (CNS) polypharmacy in active duty service members and veterans. The study found that CNS polypharmacy was independently associated with significantly higher odds of overdose and suicide-related behaviors. The purpose of this medication use evaluation is to evaluate current CNS polypharmacy prescribing patterns at the Veterans Affairs (VA) Salt Lake City Health Care System and identify opportunities to optimize care and reduce the risk of overdose and suicide.
Methods: Patients will be identified through the Veterans Integrated Services Network 19 (VISN19) VA Academic Detailing Suicide Prevention Dashboard and Priority Panel. Patients will be included if they are prescribed 5 or more CNS medications nationally on the index date of September 24, 2018 and are actively receiving care at the VA Salt Lake City Health Care System. All data will be recorded without patient identifiers to maintain privacy and confidentiality. The primary outcome will be quantifying CNS polypharmacy at the VA Salt Lake City Health Care System compared to the national average. Secondary outcomes will include: care assessment need (CAN) percentile scores for 90 day and 1 year events, percentage of patients with suicide attempts/ideation, number emergency room visits in the previous year, and the percentage of patients due for mental health screenings, such as primary care-posttraumatic stress disorder (PC-PTSD), posttraumatic stress disorder checklist-5 (PCL-5), patient health questionnaire-2 (PHQ-2), patient health questionnaire-9 (PHQ-9). A subgroup analysis will be conducted for patients on opioid therapy or with opioid use disorder to identify patients who are candidates for, but have not been prescribed, naloxone.
Results: not applicable
Conclusion: not applicable
Katherine King– PGY1 Pharmacy Resident, VA Salt Lake City Health Care System, Salt Lake City, UT