2023
Long-term opioid therapy trajectories and overdose in patients with and without cancer.
Merlin J, Black A, Midboe A, Troszak L, Asch S, Bohnert A, Fenton B, Giannitrapani K, Glassman P, Kerns R, Silveira M, Lorenz K, Abel E, Becker W. Long-term opioid therapy trajectories and overdose in patients with and without cancer. BMJ Oncology 2023, 2: e000023. PMID: 38259328, PMCID: PMC10802123, DOI: 10.1136/bmjonc-2022-000023.Peer-Reviewed Original ResearchLong-term opioid therapyVeterans Health Administration databaseRetrospective cohort studyCornerstone of managementOpioid overdose riskHealth Administration databaseOpioid-related overdosesPresence of cancerRole of cancerOpioid receiptOpioid therapyCohort studyConclusions PatientsMost patientsObjective painOpioid risksDose/Opioid overdoseOverdose riskInternational ClassificationLower riskPatientsEffect of trajectoriesCancerAdministration database
2022
An Analysis of the Role of Mental Health in a Randomized Trial of a Walking Intervention for Black Veterans With Chronic Pain
Hammett PJ, Eliacin J, Makris UE, Allen KD, Kerns RD, Heapy A, Goldsmith ES, Meis LA, Taylor BC, Saenger M, Cross LJS, Do T, Branson M, Burgess DJ. An Analysis of the Role of Mental Health in a Randomized Trial of a Walking Intervention for Black Veterans With Chronic Pain. Journal Of Pain 2022, 24: 55-67. PMID: 36162790, DOI: 10.1016/j.jpain.2022.07.002.Peer-Reviewed Original ResearchConceptsMental health disordersPain-related disabilityCo-occurring mental health disordersUsual careChronic painHealth disordersIntensive treatmentBlack veteransVA health care systemChronic musculoskeletal painChronic pain patientsMental health diagnosesTelephone coaching sessionsHealth care systemMusculoskeletal painPain patientsBlack patientsPainSecondary analysisPatientsMental healthCare systemHealth diagnosisIntervention effectivenessDisordersLong-term Opioid Therapy and Overdose in Patients with and without Cancer
Merlin J, Black A, Midboe A, Troszak L, Asch S, Bohnert A, Fenton B, Giannitrapani K, Glassman P, Kerns R, Silveira M, Lorenz K, Becker W. Long-term Opioid Therapy and Overdose in Patients with and without Cancer. Journal Of Pain 2022, 23: 60. DOI: 10.1016/j.jpain.2022.03.225.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyCox proportional hazard modelingElectronic health record databaseCancer pain managementRetrospective cohort studyProportional hazard modelingOpioid overdose riskHealth record databasePresence of cancerRole of cancerOpioid receiptCohort entryCohort studyHazard ratioMost patientsPain managementOpioid risksDose/Inclusion criteriaOpioid overdoseOverdose riskLatent growth mixture modelingLower riskPatientsPartnering with patients in clinical trials of pain treatments: a narrative review
Holzer KJ, Veasley C, Kerns RD, Edwards RR, Gewandter JS, Langford DJ, Yaeger LH, McNicol E, Ferguson M, Turk DC, Dworkin RH, Haroutounian S. Partnering with patients in clinical trials of pain treatments: a narrative review. Pain 2022, 163: 1862-1873. PMID: 35297799, DOI: 10.1097/j.pain.0000000000002600.Peer-Reviewed Original ResearchConceptsPain treatmentClinical trialsPatient engagementNarrative reviewClinical researchPatient-centered clinical researchPain research studiesPain-related studiesMeaningful patient engagementClinical studiesPatient recruitmentPatient partnersPatientsTrialsTreatmentCurrent evaluationReviewSpecific guidanceArtificial Intelligence (AI) to improve chronic pain care: Evidence of AI learning
Piette J, Newman S, Krein S, Marinec N, Chen J, Williams D, Edmond S, Driscoll M, LaChappelle K, Maly M, Kim H, Farris K, Higgins D, Kerns R, Heapy A. Artificial Intelligence (AI) to improve chronic pain care: Evidence of AI learning. Intelligence-Based Medicine 2022, 6: 100064. DOI: 10.1016/j.ibmed.2022.100064.Peer-Reviewed Original ResearchPatient interactionsPatient subgroupsInteractive voice response callsPain-related interferenceComparative effectiveness trialChronic pain careCourse of therapyPedometer step countsDisease management programsCognitive behavioral therapyCBT-CPChronic painMore patientsPain careTreatment modalitiesTreatment recommendationsEffectiveness trialPatientsStep countBehavioral therapyClinician timeWeeksTherapy sessionsMethods DataTherapist feedback
2021
Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems
Ali J, Davis AF, Burgess DJ, Rhon DI, Vining R, Young‐McCaughan S, Green S, Kerns RD. Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems. Learning Health Systems 2021, 6: e10291. PMID: 35434355, PMCID: PMC9006531, DOI: 10.1002/lrh2.10291.Peer-Reviewed Original ResearchPragmatic clinical trialsPain management researchIntegrated health systemCo-occurring conditionsHealth systemClinical trialsEvidence-based therapiesClinical Trials NetworkVeterans Health SystemMultidisciplinary working groupPain researchEquitable careStudy settingTrials NetworkHealth inequitiesHealth equityEquitable healthcareHealthcare deliveryPainTrialsWorking GroupRelevant literaturePatientsGroupTherapy
2020
All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors
Gordon K, Manhapra A, Crystal S, Dziura J, Edelman E, Skanderson M, Kerns R, Justice A, Tate J, Becker W. All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors. Drug And Alcohol Dependence 2020, 216: 108291. PMID: 33011662, PMCID: PMC7644145, DOI: 10.1016/j.drugalcdep.2020.108291.Peer-Reviewed Original ResearchConceptsMorphine equivalent daily doseCause mortalityLong-term opioid therapyTime-updated Cox regressionStrong dose-response relationshipUnnatural deathsEquivalent daily doseDose-response relationshipOpioid doseOpioid therapyUninfected patientsOpioid useDaily doseCox regressionMortality outcomesTherapy doseHigh doseMale veteransOverdose fatalitiesOverdose mortalityPLWHMortalityHIVPatientsDose“Asking Is Never Bad, I Would Venture on That”: Patients’ Perspectives on Routine Pain Screening in VA Primary Care
Giannitrapani KF, Haverfield MC, Lo NK, McCaa MD, Timko C, Dobscha SK, Kerns RD, Lorenz KA. “Asking Is Never Bad, I Would Venture on That”: Patients’ Perspectives on Routine Pain Screening in VA Primary Care. Pain Medicine 2020, 21: 2163-2171. PMID: 32142132, DOI: 10.1093/pm/pnaa016.Peer-Reviewed Original ResearchConceptsPain screeningPrimary carePatient's perspectiveVA health care systemPain management strategiesVA primary careVeterans Health AdministrationMental health concernsHealth care systemRoutine carePatient recallPatients' perceptionsPatient recommendationsPainRoutine painHealth AdministrationHealth concernCare systemMental distressCarePatientsPsychological painScreeningTheme 1Theme 2
2019
Further Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients
Mun CJ, Otis JD, Concato J, Reid MC, Burg MM, Czlapinski R, Kerns RD. Further Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients. The Clinical Journal Of Pain 2019, 36: 227-227. PMID: 31899724, PMCID: PMC7060927, DOI: 10.1097/ajp.0000000000000796.Peer-Reviewed Original ResearchSignature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers
Giannitrapani KF, Fereydooni S, Azarfar A, Silveira MJ, Glassman PA, Midboe AM, Bohnert ABS, Zenoni MA, Kerns RD, Pearlman RA, Asch SM, Becker W, Lorenz KA. Signature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers. Journal Of Pain And Symptom Management 2019, 59: 49-57. PMID: 31476361, DOI: 10.1016/j.jpainsymman.2019.08.020.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyCancer-related painOpioid therapyVeterans Health Administration medical centersInformed consentAppropriate literacy levelPerspectives of patientsPatient-provider relationshipCancer-related concernsOpioid useOpioid prescribersPatient interviewsPatient educationMedical CenterPatientsPainProvider perspectivesTherapyCancerConsentLiteracy levelsProvidersPotential disadvantagesEmergent themesOpioids
2018
An evaluation of the feasibility, acceptability, and preliminary efficacy of cognitive-behavioral therapy for opioid use disorder and chronic pain
Barry DT, Beitel M, Cutter CJ, Fiellin DA, Kerns RD, Moore BA, Oberleitner L, Madden LM, Liong C, Ginn J, Schottenfeld RS. An evaluation of the feasibility, acceptability, and preliminary efficacy of cognitive-behavioral therapy for opioid use disorder and chronic pain. Drug And Alcohol Dependence 2018, 194: 460-467. PMID: 30508769, PMCID: PMC6312460, DOI: 10.1016/j.drugalcdep.2018.10.015.Peer-Reviewed Original ResearchConceptsOpioid use disorderCognitive behavioral therapyChronic painPreliminary efficacyDrug counselingUse disordersImproved pain outcomesProportion of patientsMethadone-maintained patientsNonmedical opioid useEnd of treatmentPrimary study aimPatient satisfaction ratingsManualized cognitive behavioral therapyOpioid usePain outcomesPain interferenceClinical trialsStandard drug counselingPatientsMean sessionSecondary aimStudy aimPainPilot studyRacial disparities in discontinuation of long-term opioid therapy following illicit drug use among black and white patients
Gaither JR, Gordon K, Crystal S, Edelman EJ, Kerns RD, Justice AC, Fiellin DA, Becker WC. Racial disparities in discontinuation of long-term opioid therapy following illicit drug use among black and white patients. Drug And Alcohol Dependence 2018, 192: 371-376. PMID: 30122319, PMCID: PMC7106601, DOI: 10.1016/j.drugalcdep.2018.05.033.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyIllicit drug useUrine drug testsDrug useOpioid therapyWhite racePositive urine drug testDrug testsMonths of treatmentElectronic medical recordsWhite patientsChronic painPatient raceMedical recordsPatientsLogistic regressionOpioidsRacial disparitiesDrug testingCocaineCannabisTherapyCliniciansDiscontinuationPain
2017
Classifying clinical notes with pain assessment using machine learning
Fodeh SJ, Finch D, Bouayad L, Luther SL, Ling H, Kerns RD, Brandt C. Classifying clinical notes with pain assessment using machine learning. Medical & Biological Engineering & Computing 2017, 56: 1285-1292. PMID: 29280092, PMCID: PMC6014866, DOI: 10.1007/s11517-017-1772-1.Peer-Reviewed Original ResearchConceptsPain care qualityPain assessmentClinical notesChronic painMusculoskeletal diagnosesSignificant public health problemCharacteristics of patientsIntensity of painType of painPublic health problemPain sitesPain complaintsPatient reportsPainPatientsHealth problemsCare qualityFiscal year 2011Health recordsMillions of peopleComplete dataClinical applicationDiagnosisDemographic variablesWide spectrumCare coordination in epilepsy: Measuring neurologists' connectivity using social network analysis
Altalib HH, Fenton BT, Cheung KH, Pugh MJV, Bates J, Valente TW, Kerns RD, Brandt CA. Care coordination in epilepsy: Measuring neurologists' connectivity using social network analysis. Epilepsy & Behavior 2017, 73: 31-35. PMID: 28605631, DOI: 10.1016/j.yebeh.2017.05.026.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationCare coordinationHealth care providersCare providersVA facilitiesEpilepsy centersSpecialty careEpilepsy careEpilepsy patientsHealth AdministrationFacility levelNumber of providersNeurologistsFacility typeCareProvidersType of facilityMixed modelsSame facilityPatientsEpilepsyAdministrationErratum to: Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV
Becker WC, Gordon K, Edelman EJ, Kerns RD, Crystal S, Dziura JD, Fiellin LE, Gordon AJ, Goulet JL, Justice AC, Fiellin DA. Erratum to: Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV. AIDS And Behavior 2017, 21: 1228-1228. PMID: 28188459, DOI: 10.1007/s10461-017-1725-6.Peer-Reviewed Case Reports and Technical NotesHIVPatientsImpact 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 initiativesPrescribingPatientsOpioidsClassifying Clinical Notes with Pain Assessment.
Fodeh SJ, Finch D, Bouayad L, Luther S, Kerns RD, Brandt C. Classifying Clinical Notes with Pain Assessment. 2017, 245: 1261. PMID: 29295346.Peer-Reviewed Original Research
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 mortalityMortalityCommunicating 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 careSeizuresNeurologistsUsing Patient Perspectives to Inform the Development of a Behavioral Intervention for Chronic Pain in Patients with HIV: A Qualitative Study
Merlin JS, Young SR, Johnson MO, Saag M, Demonte W, Modi R, Shurbaji S, Anderson WA, Kerns R, Bair MJ, Kertesz S, Davies S, Turan JM. Using Patient Perspectives to Inform the Development of a Behavioral Intervention for Chronic Pain in Patients with HIV: A Qualitative Study. Pain Medicine 2016, 18: 879-888. PMID: 27425186, PMCID: PMC6279265, DOI: 10.1093/pm/pnw150.Peer-Reviewed Original ResearchConceptsChronic painPatient preferencesBehavioral interventionsNonpharmacologic treatmentsHIV statusPatient's perspectivePainHIVElicit participants' preferencesIntervention contentThematic analysis approachIntervention developmentPsychosocial vulnerabilityInterventionGroup participantsPatientsGroup sessionsTarget populationFocus groupsQualitative studyPeer leadershipParticipants' preferencesIndividualsEmergent themesDelivery