2023
Fall-related Injuries and Opioid Administration Among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers
Wang H, Cai S, Caprio T, Goulet J, Intrator O. Fall-related Injuries and Opioid Administration Among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers. Medical Care 2023, 61: 579-586. PMID: 37476853, DOI: 10.1097/mlr.0000000000001889.Peer-Reviewed Original ResearchConceptsFall-related injuriesOpioid Safety InitiativeOpioid administrationCLC residentsVeterans Affairs Community Living CentersAlzheimer's diseasePropensity scoreSafety initiativesMinimum Data Set assessmentsMedication administration dataOpioid use reductionPrescription refill dataCommunity Living CentersMedicare Part D dataNursing home residentsLong-stay residentsPart D dataNonopioid usersOpioid useRefill dataUntreated painHome residentsVA CLCsAdjusted probabilityCare recordsGraded chronic pain scale revised: validation in a Veteran sample
Taub C, Gordon K, Goulet J, Lee A, Mayhew M, Von Korff M, DeBar L, Kerns R. Graded chronic pain scale revised: validation in a Veteran sample. Pain Medicine 2023, 24: 1169-1175. PMID: 37220899, PMCID: PMC10546477, DOI: 10.1093/pm/pnad068.Peer-Reviewed Original ResearchConceptsGraded Chronic Pain ScaleHigh-impact chronic painAdjusted odds ratioMild chronic painChronic Pain ScaleChronic painPain scaleConfidence intervalsLong-term opioid therapyHigh-risk populationOpioid therapyPain gradeUS veteransOdds ratioActivity limitationsPainPain researchLogistic regressionVeteran sampleHealth indicatorsStudy objectiveConvergent validityValidation studyVeteransPsychological variablesOpioid use and opioid use disorder in mono and dual-system users of veteran affairs medical centers
Goulet J, Cheng Y, Becker W, Brandt C, Sandbrink F, Workman T, Ma P, Libin A, Shara N, Spevak C, Kupersmith J, Zeng-Treitler Q. Opioid use and opioid use disorder in mono and dual-system users of veteran affairs medical centers. Frontiers In Public Health 2023, 11: 1148189. PMID: 37124766, PMCID: PMC10141670, DOI: 10.3389/fpubh.2023.1148189.Peer-Reviewed Original ResearchConceptsOpioid use disorderNew opioid prescriptionsOpioid prescriptionsOUD diagnosisVA careUse disordersPrevalence of OUDVeterans Affairs Medical CenterGuideline-concordant careRetrospective cohort studyMultivariate logistic regressionNon-VA sourcesVeterans Administration dataCommunity care servicesPrescription sourceUS healthcare systemOpioid medicationsOpioid useCohort studyConcordant careActive patientsVA cliniciansIntra-class correlationMedical CenterWhite raceTrends in Risk-Adjusted Initiation and Reduction of Opioid Use among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers
Wang H, Cai S, Caprio T, Goulet J, Intrator O. Trends in Risk-Adjusted Initiation and Reduction of Opioid Use among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers. Journal Of The American Medical Directors Association 2023, 24: 1061-1067.e4. PMID: 36963437, DOI: 10.1016/j.jamda.2023.02.015.Peer-Reviewed Original ResearchConceptsCommunity Living CentersAdministration dayOpioid cohortMinimum Data SetOpioid administrationGuideline periodVeterans Affairs Community Living CentersLiving CentersMedication administration dataReduction of opioidsSafe pain reliefNursing home residentsFacility-level characteristicsHealth care professionalsVA Central OfficeQuality of careOpioid initiationOpioid dosageNonpharmacologic treatmentsOpioid usePain reliefOpioid misuseRetrospective studyCLC residentsBenzodiazepine administration
2022
Joint longitudinal trajectories of pain intensity and opioid prescription in veterans with back pain
Buta E, Gordon KS, Gueorguieva R, Becker WC, Heapy A, Bathulapalli H, Zeng Q, Redd D, Brandt C, Goulet J. Joint longitudinal trajectories of pain intensity and opioid prescription in veterans with back pain. Pharmacoepidemiology And Drug Safety 2022, 31: 1262-1271. PMID: 35996825, DOI: 10.1002/pds.5531.Peer-Reviewed Original ResearchConceptsBack painOpioid prescriptionsPain/Pain intensityRetrospective cohort studyTrajectories of painElectronic health record dataMental health diagnosesHealth record dataHigh opioidCohort studyClinical predictorsHigher oddsPainLatent class growth analysisOpioidsPain classesHealth diagnosisRecord dataVeteransLongitudinal trajectoriesPrescriptionOddsTrajectory classesDistinct patternsOpioid administration trends among long‐stay community living centers residents with dementia
Wang H, Cai S, Caprio T, Goulet J, Intrator O. Opioid administration trends among long‐stay community living centers residents with dementia. Journal Of The American Geriatrics Society 2022, 70: 2393-2403. PMID: 35397116, DOI: 10.1111/jgs.17785.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesDementiaHumansUnited StatesUnited States Department of Veterans AffairsVeteransConceptsCommunity Living CentersOpioid administrationLong-term opioid administrationPopulation-based observational studyHigh-dose opioidsMedication administration dataLong-term opioidsVA health systemMinimum Data Set dataTreatment of painLength of stayPatient-level covariatesManagement of veteransOpioid medicationsPain assessmentObservational studyOpioidsHealth outcomesAlzheimer's diseaseRelated dementiaNegative binomial regressionHealth systemFiscal year 2013Living CentersAdministration
2021
Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain
Cavanagh CE, Rosman L, Chui PW, DeRycke E, Bathulapalli H, Gandhi P, Bastian LA, Burg MM, Brandt C, Goulet JL. Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain. Heart & Lung 2021, 50: 770-774. PMID: 34225088, DOI: 10.1016/j.hrtlng.2021.04.016.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnalgesics, OpioidBack PainHeart FailureHumansMiddle AgedPain MeasurementPrescriptionsVeteransConceptsComorbid heart failureHeart failureBack painPain intensityMedication prescription patternsPain medication prescriptionsHigher likelihoodGabapentin prescriptionsNSAID prescriptionsPrescription patternsSevere painPain conditionsMedication prescriptionsClinical managementPainMusculoskeletal disordersDisorder cohortLower likelihoodVeteransFurther studiesPrescriptionFailureOpioidsCardiovascularCohort
2020
Are we missing opioid-related deaths among people with HIV?
Becker WC, Gordon KS, Edelman EJ, Goulet JL, Kerns RD, Marshall BDL, Fiellin DA, Justice AC, Tate JP. Are we missing opioid-related deaths among people with HIV? Drug And Alcohol Dependence 2020, 212: 108003. PMID: 32417360, PMCID: PMC9580216, DOI: 10.1016/j.drugalcdep.2020.108003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidCohort StudiesDrug OverdoseFemaleHIV InfectionsHumansMaleMiddle AgedOpioid-Related DisordersRisk FactorsVeteransConceptsVeterans Aging Cohort StudyOpioid useOverdose deathsLife-limiting conditionsUnnatural deathsGreater oddsAging Cohort StudyVACS IndexOpioid exposureCohort studyHIV infectionHIV statusRisk factorsOdds ratioDeath filesIndex causeHIVDisease severityDeathDecedentsIllicit useDifferential misclassificationOddsCauseOpioids
2018
Dual Use of Department of Veterans Affairs and Medicare Benefits on High‐Risk Opioid Prescriptions in Veterans Aged 65 Years and Older: Insights from the VA Musculoskeletal Disorders Cohort
Chui PW, Bastian LA, DeRycke E, Brandt CA, Becker WC, Goulet JL. Dual Use of Department of Veterans Affairs and Medicare Benefits on High‐Risk Opioid Prescriptions in Veterans Aged 65 Years and Older: Insights from the VA Musculoskeletal Disorders Cohort. Health Services Research 2018, 53: 5402-5418. PMID: 30298672, PMCID: PMC6235820, DOI: 10.1111/1475-6773.13060.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationOpioid prescriptionsHigh-risk opioid prescriptionsLong-term opioid therapyLong-term opioid useMultivariable logistic regressionMusculoskeletal disorder diagnosisMSD cohortOpioid therapyClinical characteristicsOpioid useVHA dataRetrospective analysisHealth AdministrationNational MedicareDisorder cohortDual useLogistic regressionDisorder diagnosisMedicareMedicare benefitsVeteransPrescriptionCohortAssociationOpioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care
Lisi AJ, Corcoran KL, DeRycke EC, Bastian LA, Becker WC, Edmond SN, Goertz CM, Goulet JL, Haskell SG, Higgins DM, Kawecki T, Kerns RD, Mattocks K, Ramsey C, Ruser CB, Brandt CA. Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care. Pain Medicine 2018, 19: s54-s60. PMID: 30203014, DOI: 10.1093/pm/pny114.Peer-Reviewed Original ResearchConceptsOEF/OIF/OND veteransOpioid prescriptionsChiropractic visitsOpioid useChiropractic careOperations Enduring Freedom/Iraqi Freedom/New DawnMore opioid prescriptionsVA chiropractic servicesPercentage of veteransCross-sectional analysisOpioid receiptClinic visitsClinical characteristicsCurrent smokingSevere painChiropractic clinicChiropractic servicesVisitsHigher likelihoodVeteransPrescriptionCareFurther studiesAdministrative dataOne-thirdProject 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
2017
Opioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts
Han L, Allore H, Goulet J, Bathulapali H, Skanderson M, Brandt C, Haskell S, Krebs E. Opioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts. Annals Of Epidemiology 2017, 27: 563-569.e3. PMID: 28890282, PMCID: PMC5647654, DOI: 10.1016/j.annepidem.2017.08.015.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidChronic PainDrug PrescriptionsElectronic PrescribingFemaleHumansMaleMental HealthMiddle AgedMusculoskeletal DiseasesOpioid-Related DisordersPrescription DrugsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthYoung AdultConceptsHigh-dose prescribingOpioid prescriptionsMental health diagnosesMusculoskeletal disordersDaily morphine equivalentsHealth diagnosisHigh-dose therapyLong-term opioidsHigh-dose prescriptionsAverage daily dosePosttraumatic stress disorderMorphine equivalentsDose therapyDaily dosePatient characteristicsChronic painUS veteransOdds ratioPrescribingStress disorderBaseline periodGeographic confoundingVeteransPrescriptionOpioidsMultiple Sources of Prescription Payment and Risky Opioid Therapy Among Veterans
Becker WC, Fenton BT, Brandt CA, Doyle EL, Francis J, Goulet JL, Moore BA, Torrise V, Kerns RD, Kreiner PW. Multiple Sources of Prescription Payment and Risky Opioid Therapy Among Veterans. Medical Care 2017, 55: s33-s36. PMID: 28410338, DOI: 10.1097/mlr.0000000000000722.Peer-Reviewed Original ResearchConceptsOpioid therapySource of paymentHigher oddsHigh-dose opioid therapyHigh-risk opioid prescribingMorphine equivalent daily dosePayment sourceOpioid analgesic prescriptionsPrescription monitoring programsEquivalent daily doseCross-sectional studyAnalgesic prescriptionOpioid prescribingBenzodiazepine therapyDaily doseUS veteransFiscal year 2014TherapyPrivate insuranceLogistic regressionRelated harmsPrescription paymentAnalytic sampleOpioidsOdds
2016
The Effect of Substance Use Disorders on the Association Between Guideline-concordant Long-term Opioid Therapy and All-cause Mortality
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Justice AC, Fiellin DA. The Effect of Substance Use Disorders on the Association Between Guideline-concordant Long-term Opioid Therapy and All-cause Mortality. Journal Of Addiction Medicine 2016, 10: 418-428. PMID: 27610580, PMCID: PMC5083184, DOI: 10.1097/adm.0000000000000255.Peer-Reviewed Original ResearchConceptsSubstance use disordersLong-term opioid therapyCause mortalityOpioid therapySUD treatmentUse disordersLower mortalityTime-updated Cox regressionUntreated substance use disordersVeterans Aging Cohort StudyOpioid-prescribing guidelinesGuideline-concordant careSUD statusAging Cohort StudyClinical practice guidelinesSUD treatment servicesOverall sampleHIV patientsCohort studyCox regressionPractice guidelinesPatientsTreatment servicesHigh mortalityMortalityCigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars
Bastian LA, Driscoll MA, Heapy AA, Becker WC, Goulet JL, Kerns RD, DeRycke EC, Perez E, Lynch SM, Mattocks K, Kroll-Desrosiers AR, Brandt CA, Skanderson M, Bathulapalli H, Haskell SG. Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars. Pain Medicine 2016, 18: 1089-1097. PMID: 27659441, DOI: 10.1093/pm/pnw223.Peer-Reviewed Original ResearchConceptsCurrent pain intensityOpioid prescriptionsPain intensitySmoking statusOEF/OIF/OND veteransCurrent smokersFormer smokersOpioid useVeterans Health Administration primary care clinicsOperations Enduring Freedom/Iraqi Freedom/New DawnMild pain intensityMore opioid prescriptionsSevere pain intensityNumeric rating scalePrimary care clinicsCigarette smoking statusCross-sectional analysisOpioid receiptFormer smokingCohort studyCurrent smokingCare clinicsChronic painCigarette smokersSmoking cessationThe Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Justice AC, Fiellin DA. The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality. Journal Of General Internal Medicine 2016, 31: 492-501. PMID: 26847447, PMCID: PMC4835362, DOI: 10.1007/s11606-015-3571-4.Peer-Reviewed Original ResearchConceptsSubstance use disordersGuideline-concordant careCause mortalityOpioid therapyLong-term opioid therapyUntreated substance use disordersCurrent substance use disorderTerm opioid therapyTime-updated covariatesPrimary care visitsImportant clinical outcomesMulti-modal treatmentUrine drug testingUninfected patientsUntreated patientsCare visitsChronic painClinical outcomesCox regressionDecreased riskHigh comorbidityMortality burdenRehabilitative therapySUD treatmentHigh risk
2015
Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV
Becker WC, Gordon K, Jennifer Edelman E, Kerns RD, Crystal S, Dziura JD, Fiellin LE, Gordon AJ, Goulet JL, Justice AC, Fiellin DA. Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV. AIDS And Behavior 2015, 20: 679-686. PMID: 26384973, PMCID: PMC5006945, DOI: 10.1007/s10461-015-1197-5.Peer-Reviewed Original ResearchLong-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients
Weisberg DF, Gordon KS, Barry DT, Becker WC, Crystal S, Edelman EJ, Gaither J, Gordon AJ, Goulet J, Kerns RD, Moore BA, Tate J, Justice AC, Fiellin DA. Long-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 69: 223-233. PMID: 26009831, PMCID: PMC4446730, DOI: 10.1097/qai.0000000000000591.Peer-Reviewed Original ResearchConceptsLong-term opioidsMorphine equivalent daily doseOpioid receiptRisk of deathLong-term prescriptionUninfected patientsOpioid dosesAntiretroviral therapyHazard ratioDaily dosePropensity scoreHigher opioid dosesCause mortalityHIV statusAvailable patientsMortality riskOpioidsHIVPatientsProspective analysisMortalityBenzodiazepinesDosesDeathRisk
2014
A Partnered Approach to Opioid Management, Guideline Concordant Care and the Stepped Care Model of Pain Management
Dorflinger L, Moore B, Goulet J, Becker W, Heapy AA, Sellinger JJ, Kerns RD. A Partnered Approach to Opioid Management, Guideline Concordant Care and the Stepped Care Model of Pain Management. Journal Of General Internal Medicine 2014, 29: 870-876. PMID: 25355083, PMCID: PMC4239281, DOI: 10.1007/s11606-014-3019-2.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid risk mitigation strategiesOpioid therapyGuideline-concordant careVeterans Health AdministrationPain managementStepped care modelOpioid managementChronic painPain carePrimary carePractice guidelinesCare modelHigh-dose opioidsKey ResultsThe proportionProportion of patientsNon-opioid analgesicsClinical practice guidelinesCommon presenting problemManagement of veteransPerformance improvement outcomesClinical research teamInteractive educational strategiesFour-year study periodConcordant careUsing Multiple Daily Pain Ratings to Improve Reliability and Assay Sensitivity: How Many Is Enough?
Heapy A, Dziura J, Buta E, Goulet J, Kulas JF, Kerns RD. Using Multiple Daily Pain Ratings to Improve Reliability and Assay Sensitivity: How Many Is Enough? Journal Of Pain 2014, 15: 1360-1365. PMID: 25283469, DOI: 10.1016/j.jpain.2014.09.012.Peer-Reviewed Original ResearchConceptsPain intensity ratingsPain treatment trialsPain ratingsTreatment trialsIntensity ratingsDaily pain ratingsMedical Center patientsIMMPACT recommendationsBaseline measurement periodCenter patientsPain assessmentBland-Altman analysisClinical trialsSecondary data analysisDaily callsDaily ratingsTrialsMeaningful differencesAssay sensitivityMeasure reliabilityAdequate reliabilitySpecific recommendationsPatientsSmall subsetBaseline