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Article ; Online: Magnetically controlled growing rods in the treatment of early onset scoliosis: a single centre experience of 44 patients with mean follow-up of 4.1 years.

Abdelaal, Ahmed / Munigangaiah, Sudarshan / Trivedi, Jayesh / Davidson, Neil

Bone & joint open

2020 Volume 1, Issue 7, Page(s) 405–414

Abstract: Aims: Magnetically controlled growing rods (MCGR) have been gaining popularity in the management of early-onset scoliosis (EOS) over the past decade. We present our experience with the first 44 MCGR consecutive cases treated at our institution.: ... ...

Abstract	Aims: Magnetically controlled growing rods (MCGR) have been gaining popularity in the management of early-onset scoliosis (EOS) over the past decade. We present our experience with the first 44 MCGR consecutive cases treated at our institution. Methods: This is a retrospective review of consecutive cases of MCGR performed in our institution between 2012 and 2018. This cohort consisted of 44 children (25 females and 19 males), with a mean age of 7.9 years (3.7 to 13.6). There were 41 primary cases and three revisions from other rod systems. The majority (38 children) had dual rods. The group represents a mixed aetiology including idiopathic (20), neuromuscular (13), syndromic (9), and congenital (2). The mean follow-up was 4.1 years, with a minimum of two years. Nine children graduated to definitive fusion. We evaluated radiological parameters of deformity correction (Cobb angle), and spinal growth (T1-T12 and T1-S1 heights), as well as complications during the course of treatment. Results: The mean Cobb angles pre-operatively, postoperatively, and at last follow-up were 70° (53 to 103), 35° (15 to 71) and 39° (15 to 65) respectively (p < 0.001). Further, there was a mean of 14° (-6 to 27) of additional Cobb angle correction upon graduation from MCGR to definitive fusion. Both T1-T12 and T1-S1 showed significant increase in heights of 27 mm and 45 mm respectively at last follow-up (p < 0.001). Ten children (23%) developed 18 complications requiring 21 unplanned operations. Independent risk factors for developing a complication were single rod constructs and previous revision surgery. Conclusion: MCGR has the benefit of avoiding multiple surgeries, and is an effective tool in treatment of early-onset scoliosis. It also maintains the flexibility of the spine, allowing further correction at the time of definitive fusion.Cite this article:
Language	English
Publishing date	2020-11-02
Publishing country	England
Document type	Journal Article
ISSN	2633-1462
ISSN (online)	2633-1462
DOI	10.1302/2633-1462.17.BJO-2020-0099.R1
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Article ; Online: Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis.

Howlett, Neil / Trivedi, Daksha / Troop, Nicholas A / Chater, Angel Marie

Translational behavioral medicine

2017 Volume 9, Issue 1, Page(s) 147–157

Abstract: ... were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16-0.48, n = 2,346) and ... maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12-0.30, n = 2,190 ... Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity ...

Abstract	Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at follow-up (behavior change maintenance), to identify behavior change techniques (BCT) within, and report on fidelity. Included studies were randomized controlled trials, targeting healthy inactive adults, aiming to change physical activity and/or sedentary behavior, with a minimum postintervention follow-up of 6 months, using 16 databases from 1990. Two reviewers independently coded risk of bias, the "Template for Intervention Description and Replication" (TIDieR) checklist, and BCTs. Twenty-six studies were included; 16 pooled for meta-analysis. Physical activity interventions were effective at changing behavior (d = 0.32, 95% confidence intervals = 0.16-0.48, n = 2,346) and maintaining behavior change after 6 months or more (d = 0.21, 95% confidence intervals = 0.12-0.30, n = 2,190). Sedentary behavior interventions (n = 2) were not effective. At postintervention, physical activity intervention effectiveness was associated with the BCTs "Biofeedback," "Demonstration of the behavior," "Behavior practice/rehearsal," and "Graded tasks." At follow-up, effectiveness was associated with using "Action planning," "Instruction on how to perform the behavior," "Prompts/cues," "Behavior practice/rehearsal," "Graded tasks," and "Self-reward." Fidelity was only documented in one study. Good evidence was found for behavior change maintenance effects in healthy inactive adults, and underlying BCTs. This review provides translational evidence to improve research, intervention design, and service delivery in physical activity interventions, while highlighting the lack of fidelity measurement.
MeSH term(s)	Behavior Therapy/methods ; Exercise ; Health Behavior ; Health Promotion/methods ; Humans ; Sedentary Behavior
Language	English
Publishing date	2017-12-20
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2586893-7
ISSN	1613-9860 ; 1869-6716
ISSN (online)	1613-9860
ISSN	1869-6716
DOI	10.1093/tbm/iby010
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Article ; Online: Association of Mental Health Treatment With Outcomes for US Veterans Diagnosed With Non-Small Cell Lung Cancer.

Berchuck, Jacob E / Meyer, Craig S / Zhang, Ning / Berchuck, Caroline M / Trivedi, Neil N / Cohen, Beth / Wang, Sunny

JAMA oncology

2020 Volume 6, Issue 7, Page(s) 1055–1062

Abstract: Importance: Preexisting mental health disorders (MHDs) are associated with increased mortality in people diagnosed with cancer, yet few data exist on the efficacy of interventions to mitigate this disparity.: Objective: To evaluate the association of ...

Abstract	Importance: Preexisting mental health disorders (MHDs) are associated with increased mortality in people diagnosed with cancer, yet few data exist on the efficacy of interventions to mitigate this disparity. Objective: To evaluate the association of participation in mental health treatment programs (MHTPs), housing support programs, or employment support programs with stage at cancer diagnosis, receipt of stage-appropriate treatment, and mortality among patients with a preexisting MHD. Design, setting, and participants: This retrospective, population-based cohort study included 55 315 veterans in the Veterans Affairs Central Cancer Registry (VACCR) who had newly diagnosed non-small cell lung cancer (NSCLC) from September 30, 2000, to December 31, 2011. Data were analyzed from January 15, 2017, to March 17, 2020. Exposures: Mental health disorders, including schizophrenia, bipolar disorder, depressive disorder, posttraumatic stress disorder, and substance use disorder. Main outcomes and measures: Stage at cancer diagnosis, receipt of stage-appropriate cancer treatment, all-cause mortality, and lung cancer-specific mortality. Results: Of 55 315 veterans with a new diagnosis of NSCLC included in the analysis (98.1% men; mean [SD] age, 68.1 [9.8] years), 18 229 had a preexisting MHD, among whom participation in MHTPs was associated with a lower likelihood of being diagnosed in a late stage (odds ratio [OR], 0.62; 95% CI, 0.58-0.66; P < .001), a higher likelihood of receiving stage-appropriate treatment (OR, 1.55; 95% CI, 1.26-1.89; P < .001), lower all-cause mortality (adjusted hazard ratio [AHR], 0.74; 95% CI, 0.72-0.77; P < .001), and lower lung cancer-specific mortality (AHR, 0.77; 95% CI, 0.74-0.80; P < .001). Likewise, participation in housing and employment support programs was associated with similar improvements in all outcomes described above. Conclusions and relevance: In veterans with preexisting MHDs diagnosed with NSCLC, participation in MHTPs and housing and employment support programs was associated with improved lung cancer-related outcomes. This study might be the first to demonstrate significant improvement in cancer mortality for patients with MHDs who participate in MHTPs, housing support programs, or employment support programs. This work supports substantial literature that investment in mental health and social needs can improve health outcomes and highlights the importance of further research to identify, evaluate, and implement interventions to improve outcomes for patients with MHDs who are diagnosed with cancer.
MeSH term(s)	Aged ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/epidemiology ; Carcinoma, Non-Small-Cell Lung/pathology ; Employment ; Female ; Housing ; Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/drug therapy ; Lung Neoplasms/epidemiology ; Lung Neoplasms/pathology ; Male ; Mental Disorders/diagnosis ; Mental Disorders/epidemiology ; Mental Disorders/therapy ; Mental Health ; Mental Health Services ; Middle Aged ; Neoplasm Staging ; Social Support ; Treatment Outcome ; United States ; Veterans
Language	English
Publishing date	2020-06-04
Publishing country	United States
Document type	Journal Article
ISSN	2374-2445
ISSN (online)	2374-2445
DOI	10.1001/jamaoncol.2020.1466
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Article ; Online: Executive Summary: A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute-Care Hospitals: 2022 Updates.

Yokoe, Deborah S / Advani, Sonali D / Anderson, Deverick J / Babcock, Hilary M / Bell, Michael / Berenholtz, Sean M / Bryant, Kristina A / Buetti, Niccolò / Calderwood, Michael S / Calfee, David P / Dubberke, Erik R / Ellingson, Katherine D / Fishman, Neil O / Gerding, Dale N / Glowicz, Janet / Hayden, Mary K / Kaye, Keith S / Klompas, Michael / Kociolek, Larry K /

Landon, Emily / Larson, Elaine L / Malani, Anurag N / Marschall, Jonas / Meddings, Jennifer / Mermel, Leonard A / Patel, Payal K / Perl, Trish M / Popovich, Kyle J / Schaffzin, Joshua K / Septimus, Edward / Trivedi, Kavita K / Weinstein, Robert A / Maragakis, Lisa L

Infection control and hospital epidemiology

2023 Volume 44, Issue 10, Page(s) 1540–1554

MeSH term(s)	Humans ; Cross Infection/prevention & control ; Hospitals ; Delivery of Health Care
Language	English
Publishing date	2023-08-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.138
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Article ; Online: Introduction to

Yokoe, Deborah S / Advani, Sonali D / Anderson, Deverick J / Babcock, Hilary M / Bell, Michael / Berenholtz, Sean M / Bryant, Kristina A / Buetti, Niccolò / Calderwood, Michael S / Calfee, David P / Deloney, Valerie M / Dubberke, Erik R / Ellingson, Katherine D / Fishman, Neil O / Gerding, Dale N / Glowicz, Janet / Hayden, Mary K / Kaye, Keith S / Kociolek, Larry K /

Infection control and hospital epidemiology

2023 Volume 44, Issue 10, Page(s) 1533–1539

Abstract: Since the initial publication ... ...

Abstract	Since the initial publication of
MeSH term(s)	Child ; Humans ; Communicable Diseases/epidemiology ; COVID-19/epidemiology ; COVID-19/prevention & control ; Cross Infection/epidemiology ; Cross Infection/prevention & control ; Delivery of Health Care ; Hospitals ; United States/epidemiology ; Pandemics ; Communicable Disease Control
Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.158
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Article ; Online: Opioid-related emergency department visits and hospitalizations among patients with chronic gastrointestinal symptoms and disorders dually enrolled in the Department of Veterans Affairs and Medicare Part D.

Balbale, Salva N / Cao, Lishan / Trivedi, Itishree / Stulberg, Jonah J / Suda, Katie J / Gellad, Walid F / Evans, Charlesnika T / Jordan, Neil / Keefer, Laurie A / Lambert, Bruce L

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

2021 Volume 79, Issue 2, Page(s) 78–93

Abstract: Purpose: We examined the prevalence of, and factors associated with, serious opioid-related adverse drug events (ORADEs) that led to an emergency department (ED) visit or hospitalization among patients with chronic gastrointestinal (GI) symptoms and ... ...

Abstract	Purpose: We examined the prevalence of, and factors associated with, serious opioid-related adverse drug events (ORADEs) that led to an emergency department (ED) visit or hospitalization among patients with chronic gastrointestinal (GI) symptoms and disorders dually enrolled in the Department of Veterans Affairs (VA) and Medicare Part D. Methods: In this retrospective cohort study, we used linked national patient-level data (April 1, 2011, to October 31, 2014) from the VA and Centers for Medicare and Medicaid Services to identify serious ORADEs among dually enrolled veterans with a chronic GI symptom or disorder. Outcome measures included serious ORADEs, defined as an ED visit attributed to an ORADE or a hospitalization where the principal or secondary reason for admission involved an opioid. We used multiple logistic regression models to determine factors independently associated with a serious ORADE. Results: We identified 3,430 veterans who had a chronic GI symptom or disorder; were dually enrolled in the VA and Medicare Part D; and had a serious ORADE that led to an ED visit, hospitalization, or both. The period prevalence of having a serious ORADE was 2.4% overall and 4.4% among veterans with chronic opioid use (≥90 consecutive days). Veterans with serious ORADEs were more likely to be less than 40 years old, male, white, and to have chronic abdominal pain, functional GI disorders, chronic pancreatitis, or Crohn's disease. They were also more likely to have used opioids chronically and at higher daily doses. Conclusion: There may be a considerable burden of serious ORADEs among patients with chronic GI symptoms and disorders. Future quality improvement efforts should target this vulnerable population.
MeSH term(s)	Adult ; Aged ; Analgesics, Opioid/adverse effects ; Emergency Service, Hospital ; Gastrointestinal Diseases/chemically induced ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/epidemiology ; Hospitalization ; Humans ; Male ; Medicare Part D ; Retrospective Studies ; United States/epidemiology ; United States Department of Veterans Affairs ; Veterans
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2021-09-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1224627-x
ISSN	1535-2900 ; 1079-2082
ISSN (online)	1535-2900
ISSN	1079-2082
DOI	10.1093/ajhp/zxab363
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Article ; Online: High-Dose Opioid Use Among Veterans with Unexplained Gastrointestinal Symptoms Versus Structural Gastrointestinal Diagnoses.

Balbale, Salva N / Cao, Lishan / Trivedi, Itishree / Stulberg, Jonah J / Suda, Katie J / Gellad, Walid F / Evans, Charlesnika T / Lambert, Bruce L / Jordan, Neil / Keefer, Laurie A

Digestive diseases and sciences

2021 Volume 66, Issue 11, Page(s) 3938–3950

Abstract: Background: In a cohort of Veterans dually enrolled in the Department of Veterans Affairs (VA) and Medicare Part D, we sought to describe high-dose daily opioid use among Veterans with unexplained gastrointestinal (GI) symptoms and structural GI ... ...

Abstract	Background: In a cohort of Veterans dually enrolled in the Department of Veterans Affairs (VA) and Medicare Part D, we sought to describe high-dose daily opioid use among Veterans with unexplained gastrointestinal (GI) symptoms and structural GI diagnoses and examine factors associated with high-dose use. Methods: We used linked national patient-level data from the VA and Centers for Medicare and Medicaid Services (CMS). We grouped patients into 3 subsets: those with unexplained GI symptoms (e.g., chronic abdominal pain); structural GI diagnoses (e.g., chronic pancreatitis); and those with a concurrent unexplained GI symptom and structural GI diagnosis. High-dose daily opioid use levels were examined as a binary variable [≥ 100 morphine milligram equivalents (MME)/day] and as an ordinal variable (50-99 MME/day, 100-119 MME/day, or ≥ 120 MME/day). Results: We identified 141,805 chronic GI patients dually enrolled in VA and Part D. High-dose opioid use was present in 11% of Veterans with unexplained GI symptoms, 10% of Veterans with structural GI diagnoses, and 15% of Veterans in the concurrent GI group. Compared to Veterans with only an unexplained GI symptom or structural diagnosis, concurrent GI patients were more likely to have higher daily opioid doses, more opioid days ≥ 100 MME, and higher risk of chronic use. Factors associated with high-dose use included opioid receipt from both VA and Part D, younger age, and benzodiazepine use. Conclusions: A significant subset of chronic GI patients in the VA are high-dose opioid users. Efforts are needed to reduce high-dose use among Veterans with concurrent GI symptoms and diagnoses.
MeSH term(s)	Aged ; Aged, 80 and over ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/therapeutic use ; Cohort Studies ; Dose-Response Relationship, Drug ; Drug Prescriptions ; Female ; Gastrointestinal Diseases/chemically induced ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/epidemiology ; Humans ; Male ; Middle Aged ; Opioid-Related Disorders ; Retrospective Studies ; United States ; United States Department of Veterans Affairs ; Veterans
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2021-01-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-020-06742-0
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Article ; Online: Artificial Intelligence in Quality Improvement: Reviewing Uses of Artificial Intelligence in Noninterpretative Processes from Clinical Decision Support to Education and Feedback.

Bhatia, Neil / Trivedi, Hari / Safdar, Nabile / Heilbrun, Marta E

Journal of the American College of Radiology : JACR

2020 Volume 17, Issue 11, Page(s) 1382–1387

Abstract: The radiology workflow can be segmented into three large groups: pre-interpretative processes, interpretation, and postinterpretative processes. Each stage of this workflow represents quality improvement opportunities for artificial intelligence and ... ...

Abstract	The radiology workflow can be segmented into three large groups: pre-interpretative processes, interpretation, and postinterpretative processes. Each stage of this workflow represents quality improvement opportunities for artificial intelligence and machine learning. Although the focus of recent research has been targeted toward optimization of image interpretation, this article describes significant use cases for artificial intelligence in both the pre-interpretative and postinterpretative aspects of radiology. We provide examples of how current applications of AI for quality improvement purposes across the radiology workflow have been implemented and how further integration of these technologies can significantly improve clinical efficiency, reduce radiologist work burden, and ultimately optimize patient care and outcomes.
MeSH term(s)	Algorithms ; Artificial Intelligence ; Decision Support Systems, Clinical ; Feedback ; Humans ; Quality Improvement
Language	English
Publishing date	2020-11-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274861-1
ISSN	1558-349X ; 1546-1440
ISSN (online)	1558-349X
ISSN	1546-1440
DOI	10.1016/j.jacr.2020.08.002
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Article ; Online: Determinants of weekly sitting time: construct validation of an initial COM-B model and comparison of its predictive validity with the Theory of Planned Behaviour.

Howlett, Neil / Schulz, Joerg / Trivedi, Daksha / Troop, Nicholas / Chater, Angel

Psychology & health

2020 Volume 36, Issue 1, Page(s) 96–114

Abstract: Objective: In relation to sitting behaviour, to investigate which theoretical domains best formed the Capability, Opportunity, and Motivation constructs of the COM-B, and compare the predictive validity to the Theory of Planned Behaviour (TPB), taking ... ...

Abstract	Objective: In relation to sitting behaviour, to investigate which theoretical domains best formed the Capability, Opportunity, and Motivation constructs of the COM-B, and compare the predictive validity to the Theory of Planned Behaviour (TPB), taking habit strength into consideration. Design: Using a prospective design, 186 adults completed measures capturing domains from the Theoretical Domains Framework for the three COM-B constructs, and habit strength, which were examined using a formative measurement model. Predictive validity was then compared to the TPB. Main outcome measures: Self-reported sitting behaviour. Results: Self-monitoring (behavioural regulation domain) formed Capability; subjective norm (social influences domain) formed Opportunity; intention (intentions domain), positive affect (emotion domain), and perceived behavioural control (beliefs about capabilities domain), formed Motivation. The COM-B strongly predicted sitting behaviour (27% variance explained), with Capability, Opportunity, and habit strength as key drivers. The TPB explained a large amount of variance (23%) in sitting behaviour, with intention and habit strength as key drivers. Conclusions: The behavioural regulation domain of Capability, the social influences domain of Opportunity, and habit strength were important drivers of sitting behaviour, with comparable variance predicted in the COM-B and TPB. Future research should consider this approach to conceptualise the COM-B for specific populations and behaviours.
MeSH term(s)	Adult ; Female ; Habits ; Humans ; Intention ; Male ; Models, Psychological ; Prospective Studies ; Psychological Theory ; Reproducibility of Results ; Sedentary Behavior ; Self Report ; Sitting Position ; Time Factors
Language	English
Publishing date	2020-05-14
Publishing country	England
Document type	Journal Article
ZDB-ID	625255-2
ISSN	1476-8321 ; 0887-0446
ISSN (online)	1476-8321
ISSN	0887-0446
DOI	10.1080/08870446.2020.1763994
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Article ; Online: Characteristics of Opioid Prescriptions to Veterans With Chronic Gastrointestinal Symptoms and Disorders Dually Enrolled in the Department of Veterans Affairs and Medicare Part D.

Balbale, Salva N / Cao, Lishan / Trivedi, Itishree / Stulberg, Jonah J / Suda, Katie J / Gellad, Walid F / Evans, Charlesnika T / Lambert, Bruce L / Keefer, Laurie A / Jordan, Neil

Military medicine

2021 Volume 186, Issue 9-10, Page(s) 943–950

Abstract: Introduction: Gastrointestinal (GI) symptoms and disorders affect an increasingly large group of veterans. Opioid use may be rising in this population, but this is concerning from a patient safety perspective, given the risk of dependence and lack of ... ...

Abstract	Introduction: Gastrointestinal (GI) symptoms and disorders affect an increasingly large group of veterans. Opioid use may be rising in this population, but this is concerning from a patient safety perspective, given the risk of dependence and lack of evidence supporting opioid use to manage chronic pain. We examined the characteristics of opioid prescriptions and factors associated with chronic opioid use among chronic GI patients dually enrolled in the DVA and Medicare Part D. Materials and methods: In this retrospective cohort study, we used linked, national patient-level data (from April 1, 2011, to December 31, 2014) from the VA and Centers for Medicare & Medicaid Services to identify chronic GI patients and observe opioid use. Veterans who had a chronic GI symptom or disorder were dually enrolled in VA and Part D and received ≥1 opioid prescription dispensed through the VA, Part D, or both. Chronic GI symptoms and disorders included chronic abdominal pain, chronic pancreatitis, inflammatory bowel diseases, and functional GI disorders. Key outcome measures were outpatient opioid prescription dispensing overall and chronic opioid use, defined as ≥90 consecutive days of opioid receipt over 12 months. We described patient characteristics and opioid use measures using descriptive statistics. Using multiple logistic regression modeling, we generated adjusted odds ratios and 95% CIs to determine variables independently associated with chronic opioid use. The final model included variables outlined in the literature and our conceptual framework. Results: We identified 141,805 veterans who had a chronic GI symptom or disorder, were dually enrolled in VA and Part D, and received ≥1 opioid prescription dispensed from the VA, Part D, or both. Twenty-six percent received opioids from the VA only, 69% received opioids from Medicare Part D only, and 5% were "dual users," receiving opioids through both VA and Part D. Compared to veterans who received opioids from the VA or Part D only, dual users had a greater likelihood of potentially unsafe opioid use outcomes, including greater number of days on opioids, higher daily doses, and higher odds of chronic use. Conclusions: Chronic GI patients in the VA may be frequent users of opioids and may have a unique set of risk factors for unsafe opioid use. Careful monitoring of opioid use among chronic GI patients may help to begin risk stratifying this group. and develop tailored approaches to minimize chronic use. The findings underscore potential nuances within the opioid epidemic and suggest that components of the VA's Opioid Safety Initiative may need to be adapted around veterans at a higher risk of opioid-related adverse events.
MeSH term(s)	Aged ; Analgesics, Opioid/therapeutic use ; Drug Prescriptions ; Gastrointestinal Diseases/complications ; Gastrointestinal Diseases/drug therapy ; Gastrointestinal Diseases/epidemiology ; Humans ; Medicare Part D ; Retrospective Studies ; United States ; United States Department of Veterans Affairs ; Veterans
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2021-03-11
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	391061-1
ISSN	1930-613X ; 0026-4075
ISSN (online)	1930-613X
ISSN	0026-4075
DOI	10.1093/milmed/usab095
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