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 mortalityMortalityIncrease in migraine diagnoses and guideline-concordant treatment in veterans, 2004–2012
Altalib H, Fenton B, Sico J, Goulet J, Bathulapalli H, Mohammad A, Kulas J, Driscoll M, Dziura J, Mattocks K, Kerns R, Brandt C, Haskell S. Increase in migraine diagnoses and guideline-concordant treatment in veterans, 2004–2012. Cephalalgia 2016, 37: 3-10. PMID: 26950804, DOI: 10.1177/0333102416631959.Peer-Reviewed Original ResearchConceptsBurden of migraineMigraine diagnosisVeterans Health Administration electronic health recordsGuideline-concordant treatmentGuideline-concordant careMigraine-specific medicationsICD-9 codesChi-square testHealth care systemNumber of veteransElectronic health recordsTriptan prescriptionMigraine preventionGuideline adherenceMigraine medicationsComorbid conditionsNational health care systemMigraine headacheMedicationsMigraineTime-series studyLogistic regressionCare systemPreventive medicineHealth administratorsThe 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
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 careGuideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Weisberg DF, Justice AC, Fiellin DA. Guideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans. Journal Of Pain 2014, 15: 1130-1140. PMID: 25152300, PMCID: PMC4253900, DOI: 10.1016/j.jpain.2014.08.004.Peer-Reviewed Original ResearchConceptsCurrent substance use disorderGuideline-concordant careOpioid therapyUrine drug testsHuman immunodeficiency virusSubstance use disordersUninfected patientsImmunodeficiency virusUse disordersPatient/provider characteristicsPrimary care provider visitsVeterans Affairs/DepartmentGuideline-concordant managementDrug testsCare concordantGuideline concordanceUninfected veteransProvider visitsPatient characteristicsPatient groupPrimary careClinical guidelinesPain medicineProvider characteristicsPatientsDevelopment 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