Linking VA and non-VA data to study the risk of suicide in chronic pain patients

Objective: to integrate large-scale VA and non-VA data to study the risk of suicidal ideation, suicide attempts, and intentional (suicide) and unintentional (accidental overdose) deaths in patients with chronic pain. Project Description: Current evidence suggests that people who experience chronic pain are at increased risk for a number of adverse health outcomes, including PTSD, suicide and opioid overdose. This is particularly relevant for the Veterans who are at increased risk of experiencing chronic pain and developing opioid use disorders with recent estimates suggesting that chronic pain impacts nearly half of Veterans. However, it is currently unclear whether Veterans with chronic pain who utilize both VHA and non-VHA services are at a higher risk of being prescribed opioid therapy, and subsequently at a higher risk of opioid overdose and suicide. Preventing such deaths will require a better understanding of intentional (suicide) and unintentional (accidental) deaths and the role of opioids. The Chicago team of both Northwestern and Loyola investigators will participate in the identification of patients receiving chronic opioid therapy, and establish linkages between the CDW and CDRN data for Veterans who received both VHA and non-VHA services in Chicago region. The site will participate as a subcontract awardee and execute work as described in the research plan. Payments will be made in accordance to the provided budget documents at the beginning of each project year once the funds have been awarded to coordinating site. Specific milestones/tasks by year: In years 1 and 2, site will participate in developing a data linkage strategy based on prior successful VA to non-VA linkage developed by CAPriCORN investigators. In years 3-5, site will participate in the development and validation of NLP methods and machine learning algorithms to identify VA patients seen at non -VA sites, and will use these novel algorithms to extract data from CAPriCORN dataset.