2020
Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study.
Edelman EJ, Li Y, Barry D, Brennan Braden J, Crystal S, Kerns RD, Gaither JR, Gordon KS, Manhapra A, Merlin JS, Moore BA, Oldfield BJ, Park LS, Rentsch CT, Skanderson M, Williams EC, Justice AC, Tate JP, Becker WC, Marshall BDL. Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2020, 84: 26-36. PMID: 32267658, PMCID: PMC7147724, DOI: 10.1097/qai.0000000000002310.Peer-Reviewed Original ResearchConceptsOpioid useOpioid use trajectoriesCohort studyPain interferenceSelf-reported opioid useVeterans Aging Cohort StudyVeterans Health Administration sitesInfrequent useOpioid use frequencyMarijuana useAging Cohort StudyNational cohort studyEvidence-based treatmentsGroup-based trajectory modelsProspective cohortBaseline factorsIllness severityMultivariable analysisBenzodiazepine medicationVA carePsychoactive medicationsPrescription painkillersPsychiatric symptomsHeroin useMultinomial logistic regression
2019
High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans.
Banerjee G, Edelman EJ, Barry DT, Crystal S, Gordon KS, Gordon AJ, Gaither JR, Green TC, Kerns RD, Manhapra A, Moore BA, Fiellin DA, Marshall BDL. High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans. Pain 2019, 160: 2126-2135. PMID: 31145217, PMCID: PMC6699915, DOI: 10.1097/j.pain.0000000000001606.Peer-Reviewed Original ResearchConceptsHigh-dose opioid prescriptionsOpioid prescriptionsHeroin useCohort studyPrior receiptHepatitis C virus (HCV) infection statusLong-term opioid prescriptionsPast-year heroin useVeterans Aging Cohort StudyHigh-dose opioidsOpioid-prescribing patternsProspective cohort studyAging Cohort StudyOpioid use disorderCurrent national guidelinesUnhealthy alcohol useUnited States veteransUnited States military veteransVirus infection statusPosttraumatic stress disorderOpioid receiptPrescribed opioidsPain interferenceCox regressionStates veteransPredictors of timely opioid agonist treatment initiation among veterans with and without HIV
Wyse JJ, Robbins JL, McGinnis KA, Edelman EJ, Gordon AJ, Manhapra A, Fiellin DA, Moore BA, Korthuis PT, Gaither JR, Gordon K, Skanderson M, Barry DT, Crystal S, Justice A, Kraemer KL. Predictors of timely opioid agonist treatment initiation among veterans with and without HIV. Drug And Alcohol Dependence 2019, 198: 70-75. PMID: 30878769, PMCID: PMC6836871, DOI: 10.1016/j.drugalcdep.2019.01.038.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyOpioid use disorderVeterans Aging Cohort StudyOAT initiationUninfected patientsClinical encountersNational observational cohortAging Cohort StudyAfrican American patientsImproved health outcomesAgonist therapyCohort studyObservational cohortTreatment initiationPredictive factorsEffective treatmentAdjusted modelUninfected controlsUse disordersPsychiatric diagnosisPWHClinical practicePatientsHealth outcomesRural residence
2018
A randomized clinical trial of the Recovery Line among methadone treatment patients with ongoing illicit drug use
Moore BA, Buono FD, Lloyd DP, Printz DMB, Fiellin DA, Barry DT. A randomized clinical trial of the Recovery Line among methadone treatment patients with ongoing illicit drug use. Journal Of Substance Use And Addiction Treatment 2018, 97: 68-74. PMID: 30577901, PMCID: PMC6310054, DOI: 10.1016/j.jsat.2018.11.011.Peer-Reviewed Original ResearchMeSH KeywordsAdultCognitive Behavioral TherapyCombined Modality TherapyFemaleHumansIllicit DrugsMaleMethadoneMiddle AgedNarcoticsOpiate Substitution TreatmentOutcome and Process Assessment, Health CareSelf ReportSelf-Help GroupsSelf-ManagementSubstance Abuse DetectionSubstance-Related DisordersTelephoneConceptsMethadone treatment patientsIllicit drug useDrug useTreatment patientsUrine screensOngoing illicit drug useDrug abstinencePrevious small trialsClinical efficacy trialsSelf-reported abstinenceRandomized clinical trialsIllicit drugsSubstance use disordersSelf-management systemCognitive behavioral therapyAdjunctive treatmentPrimary outcomeMethadone treatmentSmall trialsClinical trialsEfficacy trialsAbstinence outcomesUse disordersPatient engagementPatientsProject 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 practicesEfficacy of Extended-Release Naltrexone on HIV-Related and Drinking Outcomes Among HIV-Positive Patients: A Randomized-Controlled Trial
Edelman EJ, Moore BA, Holt SR, Hansen N, Kyriakides TC, Virata M, Brown ST, Justice AC, Bryant KJ, Fiellin DA, Fiellin LE. Efficacy of Extended-Release Naltrexone on HIV-Related and Drinking Outcomes Among HIV-Positive Patients: A Randomized-Controlled Trial. AIDS And Behavior 2018, 23: 211-221. PMID: 30073637, PMCID: PMC6476298, DOI: 10.1007/s10461-018-2241-z.Peer-Reviewed Original ResearchConceptsHIV-positive patientsHeavy drinking daysVACS Index scoreXR-NTXART adherenceDrinking daysIndex scoreUndetectable HIV viral loadCD4 cell countExtended-release naltrexoneDouble-blind placeboHIV viral loadRandomized-controlled trialDrinking outcomesHIV biomarkersSecondary outcomesHIV outcomesPrimary outcomeViral loadAntiretroviral adherenceClinical trialsCell countAlcohol treatmentHIVPatients
2017
Customized Recommendations and Reminder Text Messages for Automated, Computer-Based Treatment During Methadone
Moore BA, Buono FD, Printz DMB, Lloyd DP, Fiellin DA, Cutter CJ, Schottenfeld RS, Barry DT. Customized Recommendations and Reminder Text Messages for Automated, Computer-Based Treatment During Methadone. Experimental And Clinical Psychopharmacology 2017, 25: 485-495. PMID: 29251978, PMCID: PMC5737744, DOI: 10.1037/pha0000149.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPatient engagementReminder messagesPreliminary efficacy findingsMethadone-maintained patientsSubstance use disordersIllicit drug useRandomized trialsEfficacy findingsMethadone maintenanceUse disordersPatient useDrug useSystem functionBehavioral therapyComputer-based interventionsPatientsShort latencyTotal call timeTrial 2Trial 1Line callsSelf-management systemCall timeTotal contact timeMultiple 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 sampleOpioidsOddsEvaluation of an Integrated, Multidisciplinary Program to Address Unsafe Use of Opioids Prescribed for Pain
Becker WC, Edmond SN, Cervone DJ, Manhapra A, Sellinger JJ, Moore BA, Edens EL. Evaluation of an Integrated, Multidisciplinary Program to Address Unsafe Use of Opioids Prescribed for Pain. Pain Medicine 2017, 19: 1419-1424. PMID: 28371816, DOI: 10.1093/pm/pnx041.Peer-Reviewed Original ResearchConceptsPreliminary efficacyUnsafe useSubstance abuse/dependenceMultidisciplinary care teamSubstance use disorder diagnosisPrimary care physiciansAdvanced practice nursesUrine drug testingLength of treatmentStructured clinical assessmentNurse case managersAbuse/dependenceHealth system levelHigh-complexity patientsElectronic progress notesOpioid prescribedOpioid receiptCare physiciansPractice nursesPrimary careCare coordinationCare teamClinical assessmentCare modelClinic processes
2016
Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs
Edelman EJ, Moore BA, Calabrese SK, Berkenblit G, Cunningham C, Patel V, Phillips K, Tetrault JM, Shah M, Fiellin DA, Blackstock O. Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs. AIDS And Behavior 2016, 21: 1025-1033. PMID: 27896552, PMCID: PMC5344709, DOI: 10.1007/s10461-016-1612-6.Peer-Reviewed Original ResearchConceptsPrimary care physiciansPre-exposure prophylaxisCare physiciansHIV pre-exposure prophylaxisHIV risk groupMore HIVClinic patientsRisk groupsGeneral internistsPWIDAcademic general internistsPractice characteristicsDisease preventionHIVPrEPProphylaxisPatientsPhysiciansCareDrugsOnline surveyInternistsHigher willingnessLower willingnessCentral roleA Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians
Blackstock OJ, Moore BA, Berkenblit GV, Calabrese SK, Cunningham CO, Fiellin DA, Patel VV, Phillips KA, Tetrault JM, Shah M, Edelman EJ. A Cross-Sectional Online Survey of HIV Pre-Exposure Prophylaxis Adoption Among Primary Care Physicians. Journal Of General Internal Medicine 2016, 32: 62-70. PMID: 27778215, PMCID: PMC5215171, DOI: 10.1007/s11606-016-3903-z.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-HIV AgentsCross-Sectional StudiesFemaleHealth Knowledge, Attitudes, PracticeHealth PersonnelHealth Risk BehaviorsHIV InfectionsHumansMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Pre-Exposure ProphylaxisPrimary Health CareSurveys and QuestionnairesConceptsPrimary care physiciansHIV care experienceCare physiciansPrEP adoptionPrEP awarenessPractice characteristicsHIV pre-exposure prophylaxisCare experiencesAcademic primary care physiciansHIV-positive patientsPre-exposure prophylaxisHealth care providersResultsThe survey response rateSectional Online SurveyPCP adoptionHIV careKey ResultsThe survey response ratePercent of respondentsRisk compensationSurvey response ratePrEP knowledgePrEP useSelf-rated knowledgeMultivariable analysisClinical championsCognitive Behavioral Therapy Improves Treatment Outcomes for Prescription Opioid Users in Primary Care Buprenorphine Treatment
Moore BA, Fiellin DA, Cutter CJ, Buono FD, Barry DT, Fiellin LE, O'Connor PG, Schottenfeld RS. Cognitive Behavioral Therapy Improves Treatment Outcomes for Prescription Opioid Users in Primary Care Buprenorphine Treatment. Journal Of Substance Use And Addiction Treatment 2016, 71: 54-57. PMID: 27776678, PMCID: PMC5119533, DOI: 10.1016/j.jsat.2016.08.016.Peer-Reviewed Original ResearchConceptsOpioid-using patientsCognitive behavioral therapyUse patientsPhysician managementOpioid useTreatment outcomesBuprenorphine/naloxone treatmentHeroin use disorder patientsSelf-reported opioid useBehavioral therapyOpioid use groupPrevious drug treatmentUrine toxicology analysisEffects of CBTInjection drug useBaseline demographic differencesPrescription opioid usersBuprenorphine treatmentNaloxone treatmentOpioid abstinencePrescription opioidsOpioid usersOpioid categoryTreatment responseDrug treatmentStepped care model of pain management and quality of pain care in long-term opioid therapy
Moore BA, Anderson D, Dorflinger L, Zlateva I, Lee A, Gilliam W, Tian T, Khatri K, Ruser CB, Kerns RD. Stepped care model of pain management and quality of pain care in long-term opioid therapy. The Journal Of Rehabilitation Research And Development 2016, 53: 137-146. PMID: 27006068, DOI: 10.1682/jrrd.2014.10.0254.Peer-Reviewed Original Research
2015
Bridging waitlist delays with interim buprenorphine treatment: Initial feasibility
Sigmon SC, Meyer A, Hruska B, Ochalek T, Rose G, Badger GJ, Brooklyn JR, Heil SH, Higgins ST, Moore BA, Schwartz RP. Bridging waitlist delays with interim buprenorphine treatment: Initial feasibility. Addictive Behaviors 2015, 51: 136-142. PMID: 26256469, PMCID: PMC4558243, DOI: 10.1016/j.addbeh.2015.07.030.Peer-Reviewed Original ResearchConceptsInterim buprenorphine treatmentBuprenorphine treatmentWeek 2ASI drug composite scoresIllicit opioid abstinenceOpioid-dependent adultsIllicit opioid useDrug composite scoresPercent of participantsInitial feasibilityPast-month drug useWaitlist delaysOpioid cravingOpioid withdrawalBuprenorphine administrationOpioid useSecondary outcomesBuprenorphine inductionDaily medicationOpioid abstinencePrimary outcomeIllicit opioidsOpioid dependenceWeek 12Agonist maintenanceEvaluation 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 consultationLong-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients
Weisberg DF, Gordon KS, Barry DT, Becker WC, Crystal S, Edelman EJ, Gaither J, Gordon AJ, Goulet J, Kerns RD, Moore BA, Tate J, Justice AC, Fiellin DA. Long-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 69: 223-233. PMID: 26009831, PMCID: PMC4446730, DOI: 10.1097/qai.0000000000000591.Peer-Reviewed Original ResearchConceptsLong-term opioidsMorphine equivalent daily doseOpioid receiptRisk of deathLong-term prescriptionUninfected patientsOpioid dosesAntiretroviral therapyHazard ratioDaily dosePropensity scoreHigher opioid dosesCause mortalityHIV statusAvailable patientsMortality riskOpioidsHIVPatientsProspective analysisMortalityBenzodiazepinesDosesDeathRiskA Remotely-Delivered CBT and Contingency Management Therapy for Substance Using People with HIV
Moore BA, Rosen MI, Wang Y, Shen J, Ablondi K, Sullivan A, Guerrero M, Siqueiros L, Daar ES, Liu H. A Remotely-Delivered CBT and Contingency Management Therapy for Substance Using People with HIV. AIDS And Behavior 2015, 19: 156-162. PMID: 25645326, PMCID: PMC4498993, DOI: 10.1007/s10461-014-0990-x.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-Retroviral AgentsCaliforniaCognitive Behavioral TherapyDirective CounselingFeasibility StudiesFemaleHIV InfectionsHumansMaleMedication AdherenceMotivationPatient Acceptance of Health CareProgram EvaluationSubstance Abuse, IntravenousSubstance-Related DisordersTelephoneTreatment OutcomeYoung AdultConceptsAntiretroviral therapyContingency managementContingency management therapyBehavior therapy sessionsHIV patientsMedication adherenceTelephone sessionsPrescribed dosesParticipant adherenceManagement therapyPrior interventionsPromising interventionAlcohol useAdherenceTherapy sessionsHIVPatientsTherapyModest effectCognitive behavior therapy sessionsWeeksInterventionSessionsDosesCare
2014
Primary Care–Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial
Fiellin DA, Schottenfeld RS, Cutter CJ, Moore BA, Barry DT, O’Connor P. Primary Care–Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial. JAMA Internal Medicine 2014, 174: 1947-1954. PMID: 25330017, PMCID: PMC6167926, DOI: 10.1001/jamainternmed.2014.5302.Peer-Reviewed Original ResearchConceptsPrescription opioid dependenceOngoing maintenance therapyIllicit opioid useMaintenance therapyOpioid dependenceBuprenorphine taperBuprenorphine therapyTaper groupMaintenance groupOpioid usePrimary careClinical trialsPrimary care-based treatmentSignificant public health burdenBuprenorphine maintenance therapyOngoing maintenance treatmentPrimary care physiciansEvidence-based guidelinesPrimary care sitesPublic health burdenWeeks of stabilizationHydrochloride therapyOpioid withdrawalBuprenorphine treatmentNaltrexone treatmentA Partnered Approach to Opioid Management, Guideline Concordant Care and the Stepped Care Model of Pain Management
Dorflinger L, Moore B, Goulet J, Becker W, Heapy AA, Sellinger JJ, Kerns RD. A Partnered Approach to Opioid Management, Guideline Concordant Care and the Stepped Care Model of Pain Management. Journal Of General Internal Medicine 2014, 29: 870-876. PMID: 25355083, PMCID: PMC4239281, DOI: 10.1007/s11606-014-3019-2.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid risk mitigation strategiesOpioid therapyGuideline-concordant careVeterans Health AdministrationPain managementStepped care modelOpioid managementChronic painPain carePrimary carePractice guidelinesCare modelHigh-dose opioidsKey ResultsThe proportionProportion of patientsNon-opioid analgesicsClinical practice guidelinesCommon presenting problemManagement of veteransPerformance improvement outcomesClinical research teamInteractive educational strategiesFour-year study periodConcordant careA pilot trial of a videogame-based exercise program for methadone maintained patients
Cutter CJ, Schottenfeld RS, Moore BA, Ball SA, Beitel M, Savant JD, Stults-Kolehmainen MA, Doucette C, Barry DT. A pilot trial of a videogame-based exercise program for methadone maintained patients. Journal Of Substance Use And Addiction Treatment 2014, 47: 299-305. PMID: 25012555, PMCID: PMC4487635, DOI: 10.1016/j.jsat.2014.05.007.Peer-Reviewed Original ResearchConceptsExercise interventionSubstance useSubstance use disorder treatmentMethadone-maintained patientsStudy completion ratesPhysical activity levelsGreater physical activityWii Fit PlusUse disorder treatmentExercise programSedentary controlsPilot trialPhysical activityDisorder treatmentActive game playPilot studyActivity levelsInterventionPatientsCompletion ratesHigh satisfactionFurther investigationTrialsPsychological wellnessParticipants