2024
Guideline concordant opioid therapy in Veterans receiving VA and community care
Ma P, Cheng Y, Goulet J, Sandbrink F, Brandt C, Spevak C, Kean J, Becker W, Libin A, Shara N, Sheriff H, Houston J, Butler J, Workman E, Agrawal R, Kupersmith J, Zeng-Treitler Q. Guideline concordant opioid therapy in Veterans receiving VA and community care. BMC Health Services Research 2024, 24: 1284. PMID: 39456008, PMCID: PMC11515256, DOI: 10.1186/s12913-024-11742-1.Peer-Reviewed Original ResearchConceptsDual-system usersGuideline concordant careConcordant careVA servicesCommunity careElectronic health record dataHealth record dataRates of guideline concordanceVA Medical CenterOpioid therapyAdherence to specific guidelinesBaltimore VA Medical CenterGuideline adherenceGuideline concordanceAdherence ratesGuideline recommendationsRecord dataCareDemographic factorsMedical CenterVeteransComorbid conditionsOpioid crisisUrine drug screensSpecific guidelinesPrescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose.
Kazemitabar M, Howell B, Becker W, Lin H, Grau L, Heimer R, D'Onofrio G, Hawk K, Fiellin D, Black A. Prescription Opioid Dose Change Prior to Fatal Opioid-Detected Overdose. Journal Of Studies On Alcohol And Drugs 2024 PMID: 38775307, DOI: 10.15288/jsad.24-00026.Peer-Reviewed Original ResearchPrescribed opioidsOpioid dose changesRapid dose increaseNon-HispanicOverdose deathsToxicological resultsNon-prescription opioidsBlack non-HispanicMorphine equivalentsOpioid therapyWhite non-HispanicDose changesDaily doseMean ageDispensed opioidsPrescription opioidsPrescribing patternsOpioidDose increaseOpioid overdose crisisIncreasing dosesStudy investigated patternsEffect of timeEffects of ageSecondary analysis
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 induction
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 deathsMultiple 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 sampleOpioidsOddsBarriers 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
2016
Prescribing opioids in primary care: Safely starting, monitoring, and stopping
Tobin DG, Andrews R, Becker WC. Prescribing opioids in primary care: Safely starting, monitoring, and stopping. Cleveland Clinic Journal Of Medicine 2016, 83: 207-215. PMID: 26974992, DOI: 10.3949/ccjm.83a.15034.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsChronic opioid therapyChronic noncancer painPrimary care providersPrescription drug abuseNoncancer painOpioid therapyOpioid misusePrimary careCare teamCare providersEpidemic proportionsMeaningful benefitPatient communicationOpioidsDrug abuseAdverse effectsAbusePainOutpatientsPatientsTherapyCareInitial development of patient-reported instrument assessing harm, efficacy, and misuse of long-term opioid therapy
Becker WC, Fiellin DA, Black AC, Kostovich CT, Kerns RD, Fraenkel L. Initial development of patient-reported instrument assessing harm, efficacy, and misuse of long-term opioid therapy. The Journal Of Rehabilitation Research And Development 2016, 53: 127-136. PMID: 27006339, PMCID: PMC4806533, DOI: 10.1682/jrrd.2014.11.0285.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyPatient-reported instrumentOpioid therapyFurther item reductionIneffective medicationsClinical outcomesPrimary careFrequent reassessmentPatient comprehensionItem reductionGold standardEfficacyTherapyInterdisciplinary teamLevel checksCognitive interviewsMisuseHarmMedicationsPatients