Ajay Manhapra, MBBS
About
Research
Publications
2024
Chronic headaches after traumatic brain injury: Diagnostic complexity associated with increased cost
McGeary D, Swan A, Kennedy E, Dismuke-Greer C, McGeary C, Sico J, Amuan M, Manhapra A, Bouldin E, Watson P, Kenney K, Myers M, Werner J, Mitchell J, Carlson K, Delgado R, Esmaeili A, Pugh M. Chronic headaches after traumatic brain injury: Diagnostic complexity associated with increased cost. Neurorehabilitation 2024, 55: 303-317. PMID: 39422976, DOI: 10.3233/nre-230277.Peer-Reviewed Original ResearchTraumatic brain injuryChronic headacheTraumatic brain injury diagnosisPost-9/11-era veteransPost-traumatic headacheAssociated with higher costsCare burdenBrain injuryHealthcare costsHeadache diagnosisEra veteransClinical characteristicsHeadache disordersHigher expendituresCareVeteransIndividual headachesHigh costHeadacheIntensive treatmentRefractory headacheOutcomesDiagnosisInjuryConfoundingScreening, brief intervention, and referral to treatment for pain management for veterans separating from military service: study protocol of a hybrid type 2 study testing implementation facilitation versus training-as-usual
Sellinger J, Rosen M, Lazar C, Gilstad-Hayden K, Dziura J, Li F, Mattocks K, Weede A, Sullivan-Tibbs M, Rose L, Vassallo G, Manhapra A, Turner A, Vogt D, Woodward E, Hartmann C, Haskell S, Mohammad A, Martino S. Screening, brief intervention, and referral to treatment for pain management for veterans separating from military service: study protocol of a hybrid type 2 study testing implementation facilitation versus training-as-usual. Pain Medicine 2024, 25: s99-s106. PMID: 39514877, DOI: 10.1093/pm/pnae062.Peer-Reviewed Original ResearchConceptsTraining-as-usualImplementation facilitatorsReferral to treatmentCase managementBrief interventionHybrid type 2 effectiveness-implementation trialPain managementImplementation strategiesPrimary implementation outcomeSubstance misuseProportion of participantsPain careUsefulness of screeningVeteran engagementVA sitesImplementation outcomesPragmatic trialPain serviceVeteran participantsCase management systemPain intensityDischarged veteransStudy enrollmentVeteransChronic painPotential Role for Buprenorphine in the Management of Comorbid Depression Among People with Chronic Pain and Long-Term Opioid Therapy Dependence
Manhapra A, Rosenheck R, Becker W. Potential Role for Buprenorphine in the Management of Comorbid Depression Among People with Chronic Pain and Long-Term Opioid Therapy Dependence. 2024, 148-164. DOI: 10.1093/9780197675250.003.0009.Peer-Reviewed Original ResearchLong-term opioid therapyKappa-opioid receptorsChronic painOpioid receptorsKappa-opioid receptor antagonismManagement of comorbid depressionTherapeutic agentsMOR agonismOpioid therapyOpioid taperAntidepressant effectsWorsening painOpioid dependenceSafety profileAgonist actionPoor outcomeClinical trialsAssociated with worsening depressionPainEtiological driversBuprenorphineReceptor affinityComorbid depressionOpioidReceptorsThe Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury
Kennedy E, Manhapra A, Miles S, Martindale S, Rowland J, Mobasher H, Myers M, Panahi S, Walker W, Pugh M. The Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury. Journal Of Neurotrauma 2024 PMID: 38907690, DOI: 10.1089/neu.2024.0126.Peer-Reviewed Original ResearchPredictors of pain interferencePain interferenceMild traumatic brain injuryTraumatic brain injuryU.S. service membersPain intensityAssociated with pain interferenceAssociated with functional limitationsService membersRates of traumatic brain injuryPain interference scoresPain intensity scoresHistory of traumatic brain injuryProspective longitudinal observational studyNon-pain symptomsTraumatic brain injury historyLongitudinal observational studyHolistic treatment approachSymptoms of mild traumatic brain injuryBrain injuryFunctional limitationsPain scoresChronic painIdentifying fatigueTargeting comorbidities
2023
Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing
Manhapra A, MacLean R, Rosenheck R, Becker W. Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing. British Journal Of Clinical Pharmacology 2023, 90: 2962-2976. PMID: 37990580, PMCID: PMC11563311, DOI: 10.1111/bcp.15972.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyFunctional gainsChronic pain syndromeMaximum functional recoveryOngoing opioid crisisParadoxical worseningAnalgesic benefitAnalgesic therapyPain reliefPain syndromeEffective analgesicMost patientsAntinociceptive effectAntinociceptive systemChronic painFunctional recoveryOpioid actionOpioid dependenceMedical instabilityFunctional improvementPlacebo effectClinical principlesOpioid crisisTherapeutic inductionIs psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders?
Manhapra A, Zhou B, Rhee T, Rosenheck R. Is psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders? Journal Of Affective Disorders 2023, 344: 585-591. PMID: 37863364, DOI: 10.1016/j.jad.2023.10.094.Peer-Reviewed Original ResearchConceptsLifetime psychiatric disordersPast-year psychiatric disordersSevere pain interferencePain interferencePsychiatric disordersPD remissionChronic painNon-substance use psychiatric disordersPrevalence of painMental functioningLower physical functioningNational Epidemiologic SurveyRelated Conditions-IIIPoor mental functioningCommon comorbiditiesPhysical functionAdjusted oddsPhysical functioningObservational studyReduced prevalenceRemissionUS adultsDiagnostic remissionEpidemiologic SurveyPainMonotonic Association of Increasing Past-Year Substance Use Disorder across a Four-Level Trauma Post-Traumatic Stress Disorder (PTSD) Hierarchy in a Nationwide Sample
Jegede O, Manhapra A, Zhou B, Rhee T, Rosenheck R. Monotonic Association of Increasing Past-Year Substance Use Disorder across a Four-Level Trauma Post-Traumatic Stress Disorder (PTSD) Hierarchy in a Nationwide Sample. Journal Of Dual Diagnosis 2023, 19: 231-239. PMID: 37796996, DOI: 10.1080/15504263.2023.2260339.Peer-Reviewed Original ResearchConceptsSubstance use disordersTrauma exposureCurrent PTSDUse disordersComparison of adultPast-year substance use disorderSUD prevalencePTSDRelated Conditions Wave IIINational Epidemiologic SurveyTrauma groupNationwide sampleDifferential effectsGreater likelihoodSUD diagnosisUnadjusted resultsClinical consequencesHierarchical groupsEpidemiologic SurveyWave IIIAdultsDisordersMonotonic associationPrior groupPrevalenceBuprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration
Gordon A, Saxon A, Kertesz S, Wyse J, Manhapra A, Lin L, Chen W, Hansen J, Pinnell D, Huynh T, Baylis J, Cunningham F, Ghitza U, Bart G, Yu H, Sauer B. Buprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration. Drug And Alcohol Dependence 2023, 248: 109902. PMID: 37196572, PMCID: PMC10875624, DOI: 10.1016/j.drugalcdep.2023.109902.Peer-Reviewed Original ResearchConceptsOpioid use disorderVeterans Health AdministrationUse disordersHealth AdministrationOpioid use disorder treatmentHalf of patientsOpen cohort studyRetention of patientsCourse of careUse disorder treatmentLarge healthcare systemCohort studyMedian durationPatient characteristicsPatient demographicsDaily doseMedication treatmentBuprenorphine useClinical dataWhite racePatientsProportion daysDisorder treatmentMultiple coursesHealthcare systemPain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates
Manhapra A, Fortinsky R, Berg K, Ross J, Rhee T. Pain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates. The Journals Of Gerontology Series A 2023, 78: 1627-1640. PMID: 37096328, PMCID: PMC10460550, DOI: 10.1093/gerona/glad115.Peer-Reviewed Original ResearchConceptsHigh-impact chronic painChronic painPain managementOlder adultsCoronavirus diseasePain treatmentNational Health Interview SurveyNonpharmacological pain treatmentsUtilization of opioidsHealth Interview SurveyUS older adultsFirst yearOpioid useNonpharmacological treatmentsNonpharmacological interventionsTreatment utilizationLong-term effectsPainU.S. adultsPrevalenceInterview SurveyDiseaseAdultsCOVID-19 pandemicTreatmentRethinking clinically significant pain: a marker of recovery rather than a warning of injury
Manhapra A. Rethinking clinically significant pain: a marker of recovery rather than a warning of injury. Pain 2023, 164: e174-e174. PMID: 36779559, DOI: 10.1097/j.pain.0000000000002800.Peer-Reviewed Original Research