2024
Long-Term Use of Muscle Relaxant Medications for Chronic Pain
Oldfield B, Gleeson B, Morford K, Adams Z, Funaro M, Becker W, Merlin J. Long-Term Use of Muscle Relaxant Medications for Chronic Pain. JAMA Network Open 2024, 7: e2434835. PMID: 39298168, PMCID: PMC11413720, DOI: 10.1001/jamanetworkopen.2024.34835.Peer-Reviewed Original ResearchConceptsLow back painBack painSkeletal muscle relaxantsChronic painRandomized clinical trialsNeck painCohort studyEfficacy of long-term useLong-term useSystematically searched Ovid MEDLINEMuscle relaxant medicationsModerate risk of biasOpioid prescribing guidelinesRisk of biasQuality of cohort studiesWeb of SciencePainful crampsRelaxant medicationsChronic pain syndromesPainful spasmsOvid MEDLINEPrescribing guidelinesSystematic reviewIncreased prescriptionModerate riskFactors associated with participation in a walking intervention for veterans who smoke and have chronic pain
Muller R, Driscoll M, DeRycke E, Edmond S, Becker W, Bastian L. Factors associated with participation in a walking intervention for veterans who smoke and have chronic pain. Journal Of Behavioral Medicine 2024, 47: 994-1001. PMID: 39143444, DOI: 10.1007/s10865-024-00511-4.Peer-Reviewed Original ResearchFactors associated with participationCognitive behavioral interventionPain locationCounseling sessionsAverage daily step countPain self-management interventionMedian daily stepsDaily step countIntegrated smoking cessationSelf-management interventionsTelephone counseling sessionsChronic painModerate pain intensityMedian pack-yearsMultivariate logistic regressionWalking interventionLE painDaily stepsStep countsPain interferenceWalk componentSmoking cessationPain intensityPack-yearsIncreased oddsImplementation, intervention, and downstream costs for implementation of a multidisciplinary complex pain clinic in the Veterans Health Administration
Daniels S, Cave S, Wagner T, Perez T, Edmond S, Becker W, Midboe A. Implementation, intervention, and downstream costs for implementation of a multidisciplinary complex pain clinic in the Veterans Health Administration. Health Services Research 2024, 59: e14345. PMID: 38956400, PMCID: PMC11540574, DOI: 10.1111/1475-6773.14345.Peer-Reviewed Original ResearchVeterans Health AdministrationIntervention sitesIntervention costsHealth AdministrationPain clinicDownstream costsQuasi-experimental study designChronic painVA administrative dataAverage intervention costComplex chronic painRoutes of careActivity-based cost dataHealthcare utilization costsVA Medical CenterHistory of chronic painMicro-costing methodImplementation facilitatorsHospice patientsCost of treating patientsControl groupAdministrative dataInpatient costsIntervention cohortClinically similar characteristicsPain Care at Home to Amplify Function: Protocol Article.
Black A, Edmond S, Frank J, Abelleira A, Snow J, Wesolowicz D, Becker W. Pain Care at Home to Amplify Function: Protocol Article. Substance Use & Addiction Journal 2024, 29767342241236032. PMID: 38469833, DOI: 10.1177/29767342241236032.Peer-Reviewed Original ResearchPrimary care providersVeterans Health AdministrationPromote self-management strategiesImplementation facilitation strategyEffectiveness-implementation trialChronic painSelf-management strategiesGuideline-concordant practicesMedication management supportOpioid medication safetyIntervention cost-effectivenessOutcomes of alcohol useLong-term opioid therapyManagement of chronic painCognitive behavioral therapy techniquesNational Institutes of HealthPain carePain interferenceCare providersMedication safetyHealthcare providersInstitutes of HealthSelf-managementAddiction Long-termHealth Administration
2023
Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing
Manhapra A, MacLean R, Rosenheck R, Becker W. Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing. British Journal Of Clinical Pharmacology 2023, 90: 2962-2976. PMID: 37990580, PMCID: PMC11563311, DOI: 10.1111/bcp.15972.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyFunctional gainsChronic pain syndromeMaximum functional recoveryOngoing opioid crisisParadoxical worseningAnalgesic benefitAnalgesic therapyPain reliefPain syndromeEffective analgesicMost patientsAntinociceptive effectAntinociceptive systemChronic painFunctional recoveryOpioid actionOpioid dependenceMedical instabilityFunctional improvementPlacebo effectClinical principlesOpioid crisisTherapeutic inductionA Tool to Identify and Engage Patients on Risky Opioid Regimens
Griffin A, Perez T, Avoundjian T, Becker W, Midboe A. A Tool to Identify and Engage Patients on Risky Opioid Regimens. Applied Clinical Informatics 2023, 14: 1018-1026. PMID: 38151042, PMCID: PMC10752654, DOI: 10.1055/s-0043-1777126.Peer-Reviewed Original ResearchConceptsMedication regimensHigh-risk patient populationHigh-dose opioidsHigh-risk opioidPrimary care clinicsPrimary care appointmentsPrimary care staffPatient-centered careHealth care systemClinical informatics toolsOutreach letterOpioid regimensCare appointmentsCare clinicsChronic painOpioid safetyPatient populationCase reportClinic staffPatientsRegimensClinical initiativesCare staffCare initiativesOpioidsNIH HEAL Common Data Elements (CDE) implementation: NIH HEAL Initiative IDEA-CC
Adams M, Hurley R, Siddons A, Topaloglu U, Wandner L, Adams M, Arnsten J, Bao Y, Barry D, Becker W, Fiellin D, Fox A, Ghiroli M, Hanmer J, Horn B, Hurlocker M, Jalal H, Joseph V, Merlin J, Murray-Krezan C, Pearson M, Rogal S, Starrels J, Bachrach R, Witkiewitz K, Vasquez A. NIH HEAL Common Data Elements (CDE) implementation: NIH HEAL Initiative IDEA-CC. Pain Medicine 2023, 24: 743-749. PMID: 36799548, PMCID: PMC10321760, DOI: 10.1093/pm/pnad018.Peer-Reviewed Original ResearchConceptsClinical trialsClinical Trials NetworkCDE programsChronic painSecondary data analysisPainTrials NetworkDisease statesOpioidData standardsGeographical codingClinical researchHealing initiationData elementsNational InstituteTrialsDisordersFederal investmentInterventionStandard processDisorder researchSurveyed librariesCDELeveraging toolsNetwork alignment
2017
Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative
Spelman JF, Peglow S, Schwartz AR, Burgo-Black L, McNamara K, Becker WC. Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative. Pain Medicine 2017, 18: 2325-2330. PMID: 29045696, DOI: 10.1093/pm/pnx243.Peer-Reviewed Original ResearchConceptsHigh-risk patientsGroup visitsUsual carePrimary careNaloxone distributionOverdose educationLong-term opioid therapyMorphine equivalent daily dosePilot quality improvement initiativeQuality improvement pilot studyPrimary care clinicsChronic pain populationsPatient satisfaction scoresVeterans Health AdministrationQuality improvement interventionsQuality improvement initiativesPrescription of naloxoneOpioid therapyDaily doseCare clinicsChronic painPain populationNaloxone prescriptionsOpioid overdoseOverdose deathsBarriers and facilitators to use of non-pharmacological treatments in chronic pain
Becker WC, Dorflinger L, Edmond SN, Islam L, Heapy AA, Fraenkel L. Barriers and facilitators to use of non-pharmacological treatments in chronic pain. BMC Primary Care 2017, 18: 41. PMID: 28320337, PMCID: PMC5359906, DOI: 10.1186/s12875-017-0608-2.Peer-Reviewed Original ResearchConceptsPrimary care providersNominal group techniqueChronic painMean agePain treatment modalitiesProvider-reported barriersNon-pharmacological treatmentPatient-reported barriersChronic pain treatmentPatient-provider interactionsPerspectives of patientsTeam-based approachOpioid therapyPatients' skepticismPain treatmentPatient knowledgeTreatment modalitiesTreatment beliefsModifiable barriersCare providersHealthcare professionalsTreatment philosophyStaff consensusPainPatients
2010
Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain.
Starrels JL, Becker WC, Alford DP, Kapoor A, Williams AR, Turner BJ. Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain. Annals Of Internal Medicine 2010, 152: 712-20. PMID: 20513829, DOI: 10.7326/0003-4819-152-11-201006010-00004.Peer-Reviewed Original ResearchConceptsUrine drug testingOpioid treatment agreementsPrimary care settingOpioid misuseTreatment agreementsChronic painDrug testingEligible studiesCare settingsAberrant drug-related behaviorsDrug abuseMental Health Services AdministrationOpioid misuse outcomesChronic noncancer painCochrane Central RegisterProportion of patientsPrimary care studyControlled Clinical TrialsHealth Services AdministrationDrug-related behaviorsCombination of interventionsNoncancer painDiversity of interventionsOpioid medicationsCentral Register
2009
The Association Between Chronic Pain and Prescription Drug Abuse in Veterans
Becker WC, Fiellin DA, Gallagher RM, Barth KS, Ross JT, Oslin DW. The Association Between Chronic Pain and Prescription Drug Abuse in Veterans. Pain Medicine 2009, 10: 531-536. PMID: 19425211, DOI: 10.1111/j.1526-4637.2009.00584.x.Peer-Reviewed Original ResearchConceptsPrescription drug abuseChronic painIllicit drug useDrug abuseMultivariable analysisPrimary careDrug useBehavioral health evaluationPast-year illicit drug usePrimary care patientsBehavioral health assessmentCross-sectional analysisCurrent smokingCare patientsTreatment algorithmMean agePrescription medicationsProbable depressionMultivariable associationsLarge cohortPossible depressionTelephone assessmentPainPatientsYounger age