2019
Analgesic prescribing trends in a national sample of older veterans with osteoarthritis
Trentalange M, Runels T, Bean A, Kerns RD, Bair MJ, Brody AA, Brandt CA, Hwang U. Analgesic prescribing trends in a national sample of older veterans with osteoarthritis. Pain 2019, Publish Ahead of Print: &na;. PMID: 30913167, PMCID: PMC9486693, DOI: 10.1097/j.pain.0000000000001509.Peer-Reviewed Original ResearchConceptsPain intensity ratingsAnalgesic prescriptionPrescribing trendsOlder veteransIntensity ratingsNonopioid analgesic prescribingPatterns of opioidPre-post observational studyReported pain intensityInterrupted time seriesOlder U.S. veteransAcetaminophen prescriptionsAnalgesic classTotal prescribingAnalgesic prescribingOpioid prescribingPain intensityDrug prescribingObservational studyPrescribingU.S. veteransPrescribing programmeOsteoarthritisStudy periodBinomial regression models
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 practicesMixed methods formative evaluation of a collaborative care program to decrease risky opioid prescribing and increase non-pharmacologic approaches to pain management
Becker WC, Mattocks KM, Frank JW, Bair MJ, Jankowski RL, Kerns RD, Painter JT, Fenton BT, Midboe AM, Martino S. Mixed methods formative evaluation of a collaborative care program to decrease risky opioid prescribing and increase non-pharmacologic approaches to pain management. Addictive Behaviors 2018, 86: 138-145. PMID: 29576479, DOI: 10.1016/j.addbeh.2018.03.009.Peer-Reviewed Original ResearchConceptsNon-pharmacologic treatment modalitiesImplementation facilitation strategyPain management providersNon-pharmacologic approachesCollaborative care programPatient-level barriersSemi-structured qualitative phone interviewsClinical pharmacist's roleSystem-level barriersQualitative phone interviewsMixed-methods formative evaluationVeterans Affairs (VA) employeesOpioid prescribingPain managementTreatment modalitiesPharmacist's roleCare programClinical programsChange ScalePhone interviewsOpioidsQualitative themesDescriptive statisticsOrganizational readinessSubsequent rate
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
Improving pain care through implementation of the Stepped Care Model at a multisite community health center
Anderson DR, Zlateva I, Coman EN, Khatri K, Tian T, Kerns RD. Improving pain care through implementation of the Stepped Care Model at a multisite community health center. Journal Of Pain Research 2016, Volume 9: 1021-1029. PMID: 27881926, PMCID: PMC5115680, DOI: 10.2147/jpr.s117885.Peer-Reviewed Original ResearchPrimary care providersPain knowledge scoresCommunity health centersStepped care modelPain careHealth centersCare modelMultisite community health centerFederally Qualified Health CentersOpioid treatment agreementsQualified health centersUrine drug screensDocumentation of painHealth Services frameworkSafety-net practicesElectronic health recordsOpioid prescribingChart reviewPain managementPain outcomesPain treatmentChronic painPain assessmentTreatment agreementsPrimary care
2015
Combined Use of Opioids and Antidepressants in the Treatment of Pain: A Review of Veterans Health Administration Data for Patients with Pain Both With and Without Co-morbid Depression
Sellinger JJ, Sofuoglu M, Kerns RD, Rosenheck RA. Combined Use of Opioids and Antidepressants in the Treatment of Pain: A Review of Veterans Health Administration Data for Patients with Pain Both With and Without Co-morbid Depression. Psychiatric Quarterly 2015, 87: 585-593. PMID: 26646578, DOI: 10.1007/s11126-015-9411-1.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationMusculoskeletal painAntidepressant useVeterans Health Administration dataAnnual opioid prescriptionsNational VHA databasesUse of antidepressantsCo-morbid depressionTreatment of painHealth Administration dataMajor depressive disorderNon-depressed groupOpioid therapyAnalgesic benefitOpioid prescribingOpioid prescriptionsPrescribing patternsOpioid useVHA databasesFiscal year 2012Depressive disorderDepression diagnosisPainAntidepressantsOpioids
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
2013
A Research Agenda for Enhancing Appropriate Opioid Prescribing in Primary Care
Becker WC, Fraenkel L, Kerns RD, Fiellin DA. A Research Agenda for Enhancing Appropriate Opioid Prescribing in Primary Care. Journal Of General Internal Medicine 2013, 28: 1364-1367. PMID: 23568187, PMCID: PMC3785661, DOI: 10.1007/s11606-013-2422-4.Peer-Reviewed Educational MaterialsConceptsOpioid prescribingLong-term opioid therapyMulti-modal treatment planAppropriate opioid prescribingOpioid analgesic therapyPatient-reported safetyEvidence-based algorithmOpioid therapyOptimize therapyAnalgesic therapyChronic painPotent medicationsInadequate efficacyPrimary careQuality improvement workPatient sufferingMild toxicityTreatment planScant dataTherapyPrescribingEfficacyPatientsOutcomesToxicity
2011
Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management
Midboe AM, Lewis ET, Cronkite RC, Chambers D, Goldstein MK, Kerns RD, Trafton JA. Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management. Translational Behavioral Medicine 2011, 1: 35-44. PMID: 24073031, PMCID: PMC3717707, DOI: 10.1007/s13142-011-0022-6.Peer-Reviewed Original ResearchClinical decision support systemBehavioral medicine perspectiveGuideline adherencePain managementCare coordinationMedicine perspectiveChronic pain managementOpioid prescribingChronic painHealth information technologyMedication managementChronic diseasesPatient educationMedicine providersMedicine careBehavioral medicine providersKnowledge of optionsPatient careReferral decisionsBehavioral therapyCareAdherencePainManagementPrescribing
2007
Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction.
Martell BA, O'Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, Fiellin DA. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Annals Of Internal Medicine 2007, 146: 116-27. PMID: 17227935, DOI: 10.7326/0003-4819-146-2-200701160-00006.Peer-Reviewed Original ResearchConceptsChronic back painSubstance use disordersEfficacy of opioidsBack painMedication-taking behaviorUse disordersOpioid treatmentOpioid medicationsStudy qualityShort-term pain reliefCurrent substance use disorderCochrane Central RegisterLifetime substance use disorderControlled Clinical TrialsLong-term efficacyPoor study qualityEnglish-language studiesTransdermal opioidsOpioid prescribingPain reliefCentral RegisterDifferent opioidsReduced painClinical trialsNonsignificant reduction