Screening for Suicidal Ideation during Polypharmacy Clinical Encounters

Research Paper Title

Polypharmacy involving opioid, psychotropic, and central nervous system depressant medications, period prevalence and association with suicidal ideation, active component, U.S. Armed Forces, 2016.

Abstract

This report uses routinely collected data in the Defense Medical Surveillance System (DMSS) to explore the period prevalence of polypharmacy among the active component U.S. military in 2016.

The period prevalence across the Department of Defense was 10.8% and was highest for the Army (14.5%) and lowest for the Marine Corps (7.4%). Furthermore, a case control study was conducted to explore the potential association between polypharmacy and incident suicidal ideation (SI).

There was an increased adjusted odds of incident SI within 12 months following polypharmacy exposure, with adjusted odds ratios ranging from 1.53 (95% CI, 1.38-1.71) to 3.06 (95% CI, 2.00-4.70), depending on the number of qualifying polypharmacy criteria. Important limitations to the current analysis are discussed.

Results suggest that it would be prudent to screen for SI during the polypharmacy clinical encounter, particularly for persons with any of the mental health disorders considered in this report.

Inclusion of Department of Defense Suicide Event Report data along with medically coded SI in future surveillance would increase the sensitivity of identifying incident cases of SI.

Reference

Eide, R.P. 3rd. & Stahlman, S. (2018) Polypharmacy involving opioid, psychotropic, and central nervous system depressant medications, period prevalence and association with suicidal ideation, active component, U.S. Armed Forces, 2016. MSMR. 25(6), pp.2-9.

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