Volume 53 | Number S3 | December 2018

Abstract List

Philip W. Chui M.D., Lori A. Bastian M.D., M.P.H., Eric DeRycke M.P.H., Cynthia A. Brandt M.D., M.P.H., William C. Becker M.D., Joseph L. Goulet Ph.D.


To examine the association of dual use of both Veterans Health Administration () and Medicare benefits with high‐risk opioid prescriptions among Veterans aged 65 years and older with a musculoskeletal disorder diagnosis.

Data Sources/Study Setting

Data were obtained from the Musculoskeletal Disorder () cohort and national Medicare claims data from 2008 to 2010.

Study Design

We conducted a retrospective analysis of Veterans enrolled in Medicare to examine the association of dual use with long‐term opioid use (>90 days of prescription opioids/year) and overlapping opioid prescriptions. Multivariable logistic regression was performed adjusting for demographic and clinical characteristics.

Data Collection/Extraction Methods

We identified 21,111 Veterans enrolled in Medicare who entered the cohort in 2008 and received an opioid prescription in 2010. We linked data with Medicare claims data to identify opioid prescriptions for these Veterans in 2010.

Principal Findings

As compared to Veterans who used only or Medicare, Veterans with dual use of and Medicare were significantly more likely to be prescribed long‐term opioid therapy ( = 4.61 (95 percent 4.05–5.25) and were also found to have higher median number of opioid prescriptions and higher odds of overlapping opioid prescriptions in 1 year. Patients reporting moderate‐to‐severe pain, non‐white‐race/ethnicity, and higher scoring on the Charlson comorbidity index had significantly higher odds of long‐term opioid prescriptions.


Among Veterans aged 65 years or older, dual use of both and Medicare was associated with higher odds of long‐term opioid therapy. Our findings suggest there may be benefit to combining and non‐ electronic health record data to minimize exposure to high‐risk opioid prescribing.