2021
Measuring pain care quality in the Veterans Health Administration primary care setting
Luther SL, Finch DK, Bouayad L, McCart J, Han L, Dobscha SK, Skanderson M, Fodeh SJ, Hahm B, Lee A, Goulet JL, Brandt CA, Kerns RD. Measuring pain care quality in the Veterans Health Administration primary care setting. Pain 2021, 163: e715-e724. PMID: 34724683, PMCID: PMC8920945, DOI: 10.1097/j.pain.0000000000002477.Peer-Reviewed Original ResearchConceptsPain care qualityPattern of documentationSevere pain intensityFrequency of documentationPresence of painSite of painPrimary care providersPrimary care settingCare quality indicatorsQuality improvement initiativesTotal PCQ scoresPatient characteristicsPain intensityPain carePain impactPCQ scoresCare settingsCare providersMusculoskeletal disordersFurther evaluationPainCare qualityHealthcare facilitiesImprovement initiativesUnique visits
2018
Testing implementation facilitation of a primary care-based collaborative care clinical program using a hybrid type III interrupted time series design: a study protocol
Midboe AM, Martino S, Krein SL, Frank JW, Painter JT, Chandler M, Schroeder A, Fenton BT, Troszak L, Erhardt T, Kerns RD, Becker WC. Testing implementation facilitation of a primary care-based collaborative care clinical program using a hybrid type III interrupted time series design: a study protocol. Implementation Science 2018, 13: 145. PMID: 30486877, PMCID: PMC6262952, DOI: 10.1186/s13012-018-0838-2.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCooperative BehaviorEvidence-Based PracticeHumansImplementation ScienceInservice TrainingInterrupted Time Series AnalysisPain ManagementPractice Patterns, Physicians'Primary Health CareProgram EvaluationResearch DesignUnited StatesUnited States Department of Veterans AffairsWork EngagementConceptsCollaborative care interventionVeterans Health AdministrationImplementation facilitationPrimary careCare interventionsHigh-dose opioid therapyMorphine equivalent daily doseVHA health care systemClinical programsImplementation facilitation strategyOutpatient opioid prescriptionsOpioid prescribing practicesPain management servicesCollaborative care programEquivalent daily dosePrimary care clinicsPrimary care providersRE-AIM frameworkInterrupted time seriesOpioid overdose crisisHealth care systemInterrupted time series designEligible patientsMedication taperingOpioid therapyProject STEP: Implementing the Veterans Health Administration’s Stepped Care Model of Pain Management
Edmond SN, Moore BA, Dorflinger LM, Goulet JL, Becker WC, Heapy AA, Sellinger JJ, Lee AW, Levin FL, Ruser CB, Kerns RD. Project STEP: Implementing the Veterans Health Administration’s Stepped Care Model of Pain Management. Pain Medicine 2018, 19: s30-s37. PMID: 30203015, DOI: 10.1093/pm/pny094.Peer-Reviewed Original ResearchConceptsVA Connecticut Healthcare SystemPrimary care providersVeterans Health AdministrationPain careStepped care modelCare providersPain managementCare modelHealth care utilization dataMultimodal pain careNonopioid analgesic prescribingLong-term opioidsElectronic health record dataPain intensity ratingsHealth record dataClinical health psychologyNonpharmacological servicesAnalgesic prescribingOpioid prescribingPharmacological managementNonpharmacological approachesNonpharmacological treatmentsReferral practicesPhysical therapyCare practices
2016
Improving pain care through implementation of the Stepped Care Model at a multisite community health center
Anderson DR, Zlateva I, Coman EN, Khatri K, Tian T, Kerns RD. Improving pain care through implementation of the Stepped Care Model at a multisite community health center. Journal Of Pain Research 2016, Volume 9: 1021-1029. PMID: 27881926, PMCID: PMC5115680, DOI: 10.2147/jpr.s117885.Peer-Reviewed Original ResearchPrimary care providersPain knowledge scoresCommunity health centersStepped care modelPain careHealth centersCare modelMultisite community health centerFederally Qualified Health CentersOpioid treatment agreementsQualified health centersUrine drug screensDocumentation of painHealth Services frameworkSafety-net practicesElectronic health recordsOpioid prescribingChart reviewPain managementPain outcomesPain treatmentChronic painPain assessmentTreatment agreementsPrimary careCommunicating diagnostic certainty of psychogenic nonepileptic seizures — a national study of provider documentation
Altalib HH, Elzamzamy K, Pugh MJ, Gonzalez JB, Cheung KH, Fenton BT, Kerns RD, Brandt CA, LaFrance WC. Communicating diagnostic certainty of psychogenic nonepileptic seizures — a national study of provider documentation. Epilepsy & Behavior 2016, 64: 4-8. PMID: 27723497, DOI: 10.1016/j.yebeh.2016.08.032.Peer-Reviewed Original ResearchConceptsPsychogenic nonepileptic seizuresElectronic health recordsNonepileptic seizuresVeterans Affairs electronic health recordsDiagnosis of PNESInappropriate health careMajority of patientsPrimary care providersImpressions of patientsHealth care professionalsMental health professionalsEpilepsy criteriaProvider documentationClinical impressionCare providersCare professionalsInternational LeagueDiagnostic certaintyHealth professionalsPatientsProgress notesHealth recordsHealth careSeizuresNeurologistsImplementation of telementoring for pain management in Veterans Health Administration: Spatial analysis
Carey EP, Frank JW, Kerns RD, Ho PM, Kirsh SR. Implementation of telementoring for pain management in Veterans Health Administration: Spatial analysis. The Journal Of Rehabilitation Research And Development 2016, 53: 147-156. PMID: 26934696, DOI: 10.1682/jrrd.2014.10.0247.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationProportion of veteransPain managementSCAN-ECHOSpecialty Care Access Network-ExtensionHealth AdministrationPrimary care provider participationPain specialty clinicPrimary care providersSpecialty care clinicsCommunity Healthcare OutcomesLow spatial accessCare clinicsChronic painHealthcare networkPain careGroup of hospitalsSpecialty clinicVHA sitesCare providersVeterans HomeLogistic regressionHealthcare outcomesClinicProvider participation
2015
Evaluation of a Telementoring Intervention for Pain Management in the Veterans Health Administration
Frank JW, Carey EP, Fagan KM, Aron DC, Todd-Stenberg J, Moore BA, Kerns RD, Au DH, Ho PM, Kirsh SR. Evaluation of a Telementoring Intervention for Pain Management in the Veterans Health Administration. Pain Medicine 2015, 16: 1090-1100. PMID: 25716075, DOI: 10.1111/pme.12715.Peer-Reviewed Original ResearchConceptsPrimary care providersChronic noncancer painVeterans Health AdministrationCare providersPatient panelMultivariable Cox proportional hazards modelsHealth AdministrationCox proportional hazards modelPain management competencyPhysical medicine servicesSpecialty pain clinicPain management educationPain management programProportional hazards modelSubstance use disordersNoncancer painNonopioid medicationsMedication initiationAnticonvulsant medicationPain clinicOpioid analgesicsPain managementChronic painPain careSpecialist consultation
2014
Development and application of an electronic health record information extraction tool to assess quality of pain management in primary care
Dorflinger LM, Gilliam WP, Lee AW, Kerns RD. Development and application of an electronic health record information extraction tool to assess quality of pain management in primary care. Translational Behavioral Medicine 2014, 4: 184-189. PMID: 24904702, PMCID: PMC4041928, DOI: 10.1007/s13142-014-0260-5.Peer-Reviewed Original ResearchPrimary care settingPain managementChronic painPain carePrimary careCare settingsGuideline-concordant carePrimary care providersCommon presenting problemPain expertsInter-rater reliabilityCare providersCarePresenting problemInterdisciplinary panelPainFinal toolPilot testingPresence of indicatorsSettingExtraction toolQuality indicators
2008
Innovations in the Treatment of Comorbid Persistent Pain and Posttraumatic Stress Disorder
Sellinger J, Kerns R. Innovations in the Treatment of Comorbid Persistent Pain and Posttraumatic Stress Disorder. 2008, 387-398. DOI: 10.1007/978-0-387-76894-6_32.Peer-Reviewed Original ResearchPosttraumatic stress disorderPrevalence of PTSDPrimary care settingPrimary care providersLifetime prevalenceCare settingsCare providersStress disorderAnnual healthcare visitsNational Comorbidity StudyPain-related problemsSymptoms of depressionMental Disorders text revisionHealthcare visitsPersistent painChronic painComorbidity studiesEpidemiological studiesGeneral populationPsychiatric conditionsPrevalenceStatistical ManualHealthcare systemPainDisorders
2003
Veterans reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system
Kerns RD, Otis J, Rosenberg R, Reid MC. Veterans reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system. The Journal Of Rehabilitation Research And Development 2003, 40: 371. PMID: 15080222, DOI: 10.1682/jrrd.2003.09.0371.Peer-Reviewed Original ResearchConceptsPresence of painMental health servicesHealth risk behaviorsHealth servicesVHA primary care settingsVeterans Health Administration facilitiesUse of outpatientPain management strategiesPrimary care settingPrimary care providersRatings of healthEmotional distressSelf-rated healthIndex visitHealth-related concernsPain complaintsVHA facilitiesHigh prevalenceCare settingsCare providersPainMore outpatientGreater emotional distressAdministration facilitiesAlcohol use
1998
Health Risk Behaviors and Their Relationships to Health Care Utilization Among Veterans Receiving Primary Medical Care
Benedetto M, Kerns R, Rosenberg R, Burg M, Westgate K. Health Risk Behaviors and Their Relationships to Health Care Utilization Among Veterans Receiving Primary Medical Care. Journal Of Clinical Psychology In Medical Settings 1998, 5: 441-447. DOI: 10.1023/a:1026258911757.Peer-Reviewed Original ResearchHealth care utilizationCare utilizationHealth risk behaviorsAffective distressRisk factorsRisk behaviorsBehavioral health risk factorsPrimary care providersPrimary care settingBehavioral risk factorsCurrent tobacco usePrimary medical careHealth risk factorsBehavioral health risksHealth care systemBrief self-report questionnaireBehaviour change interventionsRisk drinkingCare settingsTobacco useSelf-report questionnairesCare providersPatterns of useMedical careMild range