Stated Pain Levels, Opioid Prescription Volume, and Chronic Opioid Use Among United States Army Soldiers.

Introduction: The use of opioids has increased drastically over the past few years and decades. As a result, concerns have mounted over serious outcomes associated with chronic opioid use (COU), including dependency and death. A greater understanding of the factors that are associated with COU will be critical if prescribers are to navigate potentially competing objectives to provide compassionate care, while reducing the overall opioid use problem.

Is Provider Secure Messaging Associated With Patient Messaging Behavior? Evidence From the US Army.

Background: Secure messaging with health care providers offers the promise of improved patient-provider relationships, potentially facilitating outcome improvements. But, will patients use messaging technology in the manner envisioned by policy-makers if their providers do not actively use it?

Objective: We hypothesized that the level and type of secure messaging usage by providers might be associated with messaging initiation by their patients.

Methods: The study employed a dataset of health care and secure messaging records of more than 81,000 US Army soldiers and nearly 3000 clinicians with access to a patient portal system.

Sickle Cell Trait, Rhabdomyolysis, and Mortality among U.S. Army Soldiers.

Background: Studies have suggested that sickle cell trait elevates the risks of exertional rhabdomyolysis and death. We conducted a study of sickle cell trait in relation to these outcomes, controlling for known risk factors for exertional rhabdomyolysis, in a large population of active persons who had undergone laboratory tests for hemoglobin AS (HbAS) and who were subject to exertional-injury precautions.

Methods: We used Cox proportional-hazards models to test whether the risks of exertional rhabdomyolysis and death varied according to sickle cell trait status among 47,944 black soldiers who had undergone testing for HbAS and who were on active duty in the U.

Prediction of all-cause occupational disability among US Army soldiers.

Introduction: Long-term occupational disability rates associated with eventual discharges from military service have risen sharply among active-duty US Army soldiers during the last three decades, with important implications for soldier health and national security alike. To address this problem, we built predictive models for long-term, all-cause occupational disability and identified disability risk factors using a very large, multisource database on the total active-duty US Army.

Methods: We conducted a cross-temporal retrospective cohort study and used mixed-effects logistic regression models to derive and validate disability risk assignments.