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Volume 46 Number 4, 2009
   Pages 463 — 468

Abstract – Central nervous system and musculoskeletal medication profile of a veteran cohort with blast-related injuries

Dustin D. French, PhD;1-3* Matthew J. Bair, MD, MS; 1-3 Elizabeth Bass, PhD;4 Robert R. Campbell, JD, MPH, PhD;5 Kris Siddharthan, PhD5
1Richard L. Roudebush Department of Veterans Affairs Medical Center, Center of Excellence on Implementing Evidence-Based Practice, Indianapolis, IN; 2Regenstrief Institute, Inc, Indianapolis, IN; 3Indiana University School of Medicine, Indianapolis, IN; 4Congressional Budget Office, Washington, DC; 5James A. Haley Veterans' Hospital, Health Services Research and Development Research Enhancement Award Program, Tampa, FL

Abstract — Abstract-Little is known about the utilization of central nervous system (CNS) and musculoskeletal (MS) medications in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans with blast-related injuries (BRIs). We followed prescription drug use among a cohort of 133 OIF/OEF veterans with BRIs by using the Joint Theatre Trauma Registry, the Tampa Polytrauma Registry, and electronic medical records. We extracted 12 months of national medication records from the Veterans Health Administration Decision Support System and analyzed them with descriptive statistics. Over the 12-month period (fiscal year 2007), CNS medications comprised 27.9% (4,225/15,143) of total prescriptions dispensed to 90.2% (120/133) of our cohort. Approximately one-half (48.9%) of the 133 patients were treated with opioid analgesics. Nearly 60% received antidepressants. More than one-half (51.1%) of patients were treated with anticonvulsants. Benzodiazepines and antipsychotics were dispensed to 17.3% and 15.8%, respectively. For MS medicines, 804 were prescribed for 48.1% (64/133) of veterans. Nearly one-fourth (24.8%) were treated with skeletal muscle relaxants. The CNS and MS medications, in general, were continuously prescribed over the 12-month study period. This study provides insight into the complex medical management involved in the care of veterans with BRIs.

Key words: blast injuries, central nervous system, medications, musculoskeletal, OIF/OEF, opioids, polytrauma, prescription drug use, rehabilitation, veterans.


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