2022
Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings
Dobscha SK, Luther SL, Kerns RD, Finch DK, Goulet JL, Brandt CA, Skanderson M, Bathulapalli H, Fodeh SJ, Hahm B, Bouayad L, Lee A, Han L. Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings. Journal Of Pain 2022, 24: 273-281. PMID: 36167230, PMCID: PMC9898089, DOI: 10.1016/j.jpain.2022.08.009.Peer-Reviewed Original ResearchConceptsPain care qualityQuality pain careMental health conditionsPrimary care cliniciansVeterans Health AdministrationPain carePCQ scoresHealth conditionsCare cliniciansUse disordersCare qualitySevere musculoskeletal painRetrospective cohort studyPrimary care visitsGeneral medical carePrimary care settingElectronic health record dataFinal adjusted modelMental health diagnosesEquation Poisson modelsHealth record dataBipolar disorder diagnosisSubstance use disordersAlcohol use disorderPost-traumatic stress disorder
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 visitsMilitary sexual trauma and suicidal ideation in VHA-care-seeking OEF/OIF/OND veterans without mental health diagnosis or treatment
Decker SE, Ramsey CM, Ronzitti S, Kerns RD, Driscoll MA, Dziura J, Skanderson M, Bathulapalli H, Brandt CA, Haskell SG, Goulet JL. Military sexual trauma and suicidal ideation in VHA-care-seeking OEF/OIF/OND veterans without mental health diagnosis or treatment. Psychiatry Research 2021, 303: 114089. PMID: 34247061, DOI: 10.1016/j.psychres.2021.114089.Peer-Reviewed Original ResearchConceptsMental health diagnosesMilitary sexual traumaVeterans Healthcare AdministrationSuicidal ideationHealth diagnosisSexual traumaRelative risk estimatesOEF/OIF/OND veteransSample of veteransPost-9/11 veteransSuicide risk factorsMental health concernsClinical remindersRisk factorsRelative riskHigh riskMen veteransMental healthcareHealth concernRisk estimatesMST survivorsWomenDiagnosisTraumaVeterans
2020
Neuropsychological assessments and psychotherapeutic services in Veterans with multiple sclerosis: Rates of utilization and their associations with socio-demographics and clinical characteristics using Veterans Health Administration-based data
Gromisch ES, Kulas JF, Altalib H, Kerns RD, Mattocks KM, Brandt CA, Haskell S. Neuropsychological assessments and psychotherapeutic services in Veterans with multiple sclerosis: Rates of utilization and their associations with socio-demographics and clinical characteristics using Veterans Health Administration-based data. Multiple Sclerosis And Related Disorders 2020, 43: 102220. PMID: 32480347, DOI: 10.1016/j.msard.2020.102220.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationCo-occurring conditionsMultiple sclerosisWomen Veterans Cohort StudyService utilizationClinical characteristicsMood disordersService useHealth AdministrationVHA Corporate Data WarehouseNeuropsychological assessmentAlcohol-related disordersTraumatic brain injuryMental health servicesPsychotherapeutic servicesCorporate Data WarehouseRace/ethnicityCohort studyDiagnosis dateBrain injuryComprehensive careSleep disordersInitial appointmentSubsequent logistic regressionCognitive disorders
2018
Project 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 practicesUnderstanding Pain and Pain Treatment for Veterans: Responding to the Federal Pain Research Strategy
Bastian LA, Heapy A, Becker WC, Sandbrink F, Atkins D, Kerns RD. Understanding Pain and Pain Treatment for Veterans: Responding to the Federal Pain Research Strategy. Pain Medicine 2018, 19: s1-s4. PMID: 30203012, DOI: 10.1093/pm/pny143.Peer-Reviewed Original ResearchIncreased Nonopioid Chronic Pain Treatment in the Veterans Health Administration, 2010–2016
Frank JW, Carey E, Nolan C, Kerns RD, Sandbrink F, Gallagher R, Ho PM. Increased Nonopioid Chronic Pain Treatment in the Veterans Health Administration, 2010–2016. Pain Medicine 2018, 20: 869-877. PMID: 30137520, DOI: 10.1093/pm/pny149.Peer-Reviewed Original Research
2017
Multiple 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 sampleOpioidsOddsImpact of the Opioid Safety Initiative on opioid-related prescribing in veterans
Lin LA, Bohnert ASB, Kerns RD, Clay MA, Ganoczy D, Ilgen MA. Impact of the Opioid Safety Initiative on opioid-related prescribing in veterans. Pain 2017, 158: 833-839. PMID: 28240996, DOI: 10.1097/j.pain.0000000000000837.Peer-Reviewed Original ResearchConceptsOpioid Safety InitiativeVeterans Health AdministrationConcurrent benzodiazepineDaily opioid dosageElectronic medical record dataOutpatient opioid prescriptionsSafe opioid prescribingOpioid prescribing practicesMedical record dataInterrupted time series analysisSafety initiativesOpioid dosageOpioid prescribingOpioid prescriptionsOpioid regimensOutpatient prescribingVHA patientsPrescribing practicesVHA facilitiesAdverse outcomesSafe prescribingSystem-wide initiativesPrescribingPatientsOpioids
2016
Cigarette 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 cessationImplementation 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
Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care
Kroll-Desrosiers AR, Skanderson M, Bastian LA, Brandt CA, Haskell S, Kerns RD, Mattocks KM. Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care. Women's Health Issues 2015, 26: 240-246. PMID: 26549242, DOI: 10.1016/j.whi.2015.09.010.Peer-Reviewed Original ResearchConceptsPrescription opioid usePregnancy windowsOpioid prescriptionsPsychiatric diagnosisWomen veteransPregnant veteransOpioid usePrescription opioidsVeterans Health Administration (VHA) careMultivariable logistic regression modelVeterans Health Administration (VHA) servicesNontraumatic joint disordersPain management strategiesHealth-related variablesLogistic regression modelsPhysical health variablesPotential undertreatmentVHA servicesJoint disordersVHA systemOperation Enduring FreedomBack problemsOpioidsHealth variablesNational databaseEvaluation 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 consultationPrevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration
Barry DT, Sofuoglu M, Kerns RD, Wiechers IR, Rosenheck RA. Prevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration. Psychiatry Research 2015, 227: 324-332. PMID: 25863822, DOI: 10.1016/j.psychres.2015.03.006.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-Anxiety AgentsAntidepressive AgentsDrug PrescriptionsFemaleHumansHypnotics and SedativesMaleMental DisordersOpioid-Related DisordersPrevalencePsychotropic DrugsSleep Initiation and Maintenance DisordersUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsMental health clinicsPsychotropic medicationsOpioid prescriptionsHealth clinicsMedical indicationsAnxiolytics/sedatives/hypnoticsLong-term opioid useSpecialty mental health clinicsService use correlatesRelated adverse eventsSedative/hypnoticsVeterans Health AdministrationMental health treatmentAdverse eventsOpioid useHarmful side effectsFiscal year 2012More psychotropicsSide effectsPsychiatric diagnosisHealth treatmentMedicationsHealth AdministrationPsychotropicsAnxiety disorders
2014
Trends and Regional Variation in Opioid Overdose Mortality Among Veterans Health Administration Patients, Fiscal Year 2001 to 2009
Bohnert AS, Ilgen MA, Trafton JA, Kerns RD, Eisenberg A, Ganoczy D, Blow FC. Trends and Regional Variation in Opioid Overdose Mortality Among Veterans Health Administration Patients, Fiscal Year 2001 to 2009. The Clinical Journal Of Pain 2014, 30: 605-612. PMID: 24281278, DOI: 10.1097/ajp.0000000000000011.Peer-Reviewed Original ResearchConceptsVeterans Health Administration patientsOpioid prescribingOverdose ratesNational Health SystemOverdose mortalityNational Death Index recordsHealth systemRate of overdosesPrescription opioid overdosesVeterans Health AdministrationOpioid overdose mortalityOpioid overdose deathsOverdose prevention strategiesPopulation-level associationPatient populationMedical recordsOpioid overdosesSemisynthetic opioidsOverdose deathsGeneral populationOpioid policyPrevention strategiesOpioidsHealth AdministrationPrescribing
2011
Nonmedical use of prescription opioids and pain in veterans with and without HIV
Barry DT, Goulet JL, Kerns RK, Becker WC, Gordon AJ, Justice AC, Fiellin DA. Nonmedical use of prescription opioids and pain in veterans with and without HIV. Pain 2011, 152: 1133-1138. PMID: 21354703, PMCID: PMC3086805, DOI: 10.1016/j.pain.2011.01.038.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidChi-Square DistributionCohort StudiesFemaleHealth SurveysHIV InfectionsHumansLogistic ModelsMaleMental DisordersMiddle AgedOdds RatioOpioid-Related DisordersPainPain MeasurementPrescriptionsPsychiatric Status Rating ScalesRetrospective StudiesSelf ReportSurveys and QuestionnairesVeterans HealthYoung AdultConceptsHuman immunodeficiency virusPrescription opioidsComponent summaryHIV statusPain interferenceUse disordersForm Health Survey Mental Component SummarySF-12 Physical Component SummaryVeterans Aging Cohort StudyNonmedical usePharmacy record dataAlcohol Use Disorders Identification Test (AUDIT) scoresAging Cohort StudyPhysical component summaryMental component summaryOpioid use disorderMedian participant ageDrug use disordersLegitimate medical reasonsPast-month cigarette useChi-squared testU.S. military veteransHepatitis COpioid prescriptionsCohort study