2022
Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings
Dobscha SK, Luther SL, Kerns RD, Finch DK, Goulet JL, Brandt CA, Skanderson M, Bathulapalli H, Fodeh SJ, Hahm B, Bouayad L, Lee A, Han L. Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings. Journal Of Pain 2022, 24: 273-281. PMID: 36167230, PMCID: PMC9898089, DOI: 10.1016/j.jpain.2022.08.009.Peer-Reviewed Original ResearchConceptsPain care qualityQuality pain careMental health conditionsPrimary care cliniciansVeterans Health AdministrationPain carePCQ scoresHealth conditionsCare cliniciansUse disordersCare qualitySevere musculoskeletal painRetrospective cohort studyPrimary care visitsGeneral medical carePrimary care settingElectronic health record dataFinal adjusted modelMental health diagnosesEquation Poisson modelsHealth record dataBipolar disorder diagnosisSubstance use disordersAlcohol use disorderPost-traumatic stress disorderAssociation Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy
Black AC, Zeliadt SB, Kerns RD, Skanderson M, Wang R, Gelman H, Douglas JH, Becker WC. Association Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy. The Clinical Journal Of Pain 2022, 38: 405-409. PMID: 35440528, DOI: 10.1097/ajp.0000000000001039.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyMorphine equivalent daily doseVeterans Health AdministrationDaily doseCIH exposureOpioid doseOpioid therapyWhole health systemCIH useVHA electronic health recordsIntegrative health modalitiesOpioid analgesic doseMean starting doseMental health diagnosesElectronic health recordsAnalgesic doseCIH therapiesNonopioid treatmentCohort entryOpioid taperingStarting doseAdverse eventsPain intensityChiropractic careVHA facilities
2021
Pain, Complex Chronic Conditions and Potential Inappropriate Medication in People with Dementia. Lessons Learnt for Pain Treatment Plans Utilizing Data from the Veteran Health Administration
Husebo BS, Kerns RD, Han L, Skanderson M, Gnjidic D, Allore HG. Pain, Complex Chronic Conditions and Potential Inappropriate Medication in People with Dementia. Lessons Learnt for Pain Treatment Plans Utilizing Data from the Veteran Health Administration. Brain Sciences 2021, 11: 86. PMID: 33440668, PMCID: PMC7827274, DOI: 10.3390/brainsci11010086.Peer-Reviewed Original ResearchChronic complex conditionsSevere pain intensityVeterans Health AdministrationPain intensityHealth AdministrationDiscontinuation of opioidsInappropriate pain managementPain treatment planPotential inappropriate medicationsInappropriate medication useComplex chronic conditionsNon-pharmacological approachesImportant risk factorAdverse drug reactionsFinal analytic sampleAnalgesic efficacyInappropriate medicationsOpioid medicationsPain medicationMedication usePain managementPersistent painChronic painMedical illnessOutpatient visits
2020
Treatment of a Large Cohort of Veterans Experiencing Musculoskeletal Disorders with Spinal Cord Stimulation in the Veterans Health Administration: Veteran Characteristics and Outcomes
Wandner LD, Fenton BT, Goulet JL, Carroll CM, Heapy A, Higgins DM, Bair MJ, Sandbrink F, Kerns RD. Treatment of a Large Cohort of Veterans Experiencing Musculoskeletal Disorders with Spinal Cord Stimulation in the Veterans Health Administration: Veteran Characteristics and Outcomes. Journal Of Pain Research 2020, 13: 1687-1697. PMID: 32753944, PMCID: PMC7354010, DOI: 10.2147/jpr.s241567.Peer-Reviewed Original ResearchMusculoskeletal disordersSCS implantsOpioid therapyPain scoresVeterans Health Administration facilitiesSpinal cord stimulator implantationOutcomes of veteransPainful musculoskeletal disordersSpinal cord stimulationVeterans Health AdministrationDepressive disorder diagnosisEvidence of benefitSubstance use disordersPercent of veteransSignificant overall decreaseMSD cohortOpioid doseBMI 25Medical comorbiditiesStimulator implantationChronic painCord stimulationInclusion diagnosisVeteran characteristicsLarge cohortNeuropsychological assessments and psychotherapeutic services in Veterans with multiple sclerosis: Rates of utilization and their associations with socio-demographics and clinical characteristics using Veterans Health Administration-based data
Gromisch ES, Kulas JF, Altalib H, Kerns RD, Mattocks KM, Brandt CA, Haskell S. Neuropsychological assessments and psychotherapeutic services in Veterans with multiple sclerosis: Rates of utilization and their associations with socio-demographics and clinical characteristics using Veterans Health Administration-based data. Multiple Sclerosis And Related Disorders 2020, 43: 102220. PMID: 32480347, DOI: 10.1016/j.msard.2020.102220.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationCo-occurring conditionsMultiple sclerosisWomen Veterans Cohort StudyService utilizationClinical characteristicsMood disordersService useHealth AdministrationVHA Corporate Data WarehouseNeuropsychological assessmentAlcohol-related disordersTraumatic brain injuryMental health servicesPsychotherapeutic servicesCorporate Data WarehouseRace/ethnicityCohort studyDiagnosis dateBrain injuryComprehensive careSleep disordersInitial appointmentSubsequent logistic regressionCognitive disordersThe Relationship Between Body Mass Index and Pain Intensity Among Veterans with Musculoskeletal Disorders: Findings from the MSD Cohort Study
Higgins DM, Buta E, Heapy AA, Driscoll MA, Kerns RD, Masheb R, Becker WC, Hausmann LRM, Bair MJ, Wandner L, Janke EA, Brandt CA, Goulet JL. The Relationship Between Body Mass Index and Pain Intensity Among Veterans with Musculoskeletal Disorders: Findings from the MSD Cohort Study. Pain Medicine 2020, 21: 2563-2572. PMID: 32186722, PMCID: PMC7778330, DOI: 10.1093/pm/pnaa043.Peer-Reviewed Original ResearchConceptsBody mass indexVeterans Health AdministrationPain intensityMass indexFunction of BMILow back pain groupOdds of painBack pain groupOverweight/obesityElectronic health record dataHealth record dataUS military veteransMusculoskeletal disorder diagnosisCohort studyOsteoarthritis groupPain groupMean ageNational cohortHigh prevalenceMSD diagnosisMusculoskeletal disordersPainHealth AdministrationDisorder diagnosisCross-sectional data“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
Core Outcome Measures for Chronic Musculoskeletal Pain Research: Recommendations from a Veterans Health Administration Work Group
Kroenke K, Krebs EE, Turk D, Von Korff M, Bair MJ, Allen KD, Sandbrink F, Cheville AL, DeBar L, Lorenz KA, Kerns RD. Core Outcome Measures for Chronic Musculoskeletal Pain Research: Recommendations from a Veterans Health Administration Work Group. Pain Medicine 2019, 20: 1500-1508. PMID: 30615172, DOI: 10.1093/pm/pny279.Peer-Reviewed Original ResearchMeSH KeywordsAnxietyBiomedical ResearchChronic PainDelphi TechniqueDepressionHumansMusculoskeletal PainOutcome Assessment, Health CarePain ManagementPain MeasurementPatient Health QuestionnairePatient Reported Outcome MeasuresPhysical Functional PerformancePsychometricsSleepUnited StatesUnited States Department of Veterans AffairsConceptsCore Outcome MeasuresOutcome measuresPain intensityPatient-reported global impressionBrief Pain Inventory Interference ScaleChronic musculoskeletal pain disordersMusculoskeletal pain disordersChronic musculoskeletal painPatient Health QuestionnaireNumerical rating scaleVeterans Health AdministrationCommon outcome measuresGeneralized anxiety disorderMusculoskeletal painPain disordersChronic painGlobal ImpressionPhysical functionHealth QuestionnairePhysical functioningSleep ScaleDepression ScaleOutcomes Information SystemPain researchHealth Administration
2018
Testing implementation facilitation of a primary care-based collaborative care clinical program using a hybrid type III interrupted time series design: a study protocol
Midboe AM, Martino S, Krein SL, Frank JW, Painter JT, Chandler M, Schroeder A, Fenton BT, Troszak L, Erhardt T, Kerns RD, Becker WC. Testing implementation facilitation of a primary care-based collaborative care clinical program using a hybrid type III interrupted time series design: a study protocol. Implementation Science 2018, 13: 145. PMID: 30486877, PMCID: PMC6262952, DOI: 10.1186/s13012-018-0838-2.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCooperative BehaviorEvidence-Based PracticeHumansImplementation ScienceInservice TrainingInterrupted Time Series AnalysisPain ManagementPractice Patterns, Physicians'Primary Health CareProgram EvaluationResearch DesignUnited StatesUnited States Department of Veterans AffairsWork EngagementConceptsCollaborative care interventionVeterans Health AdministrationImplementation facilitationPrimary careCare interventionsHigh-dose opioid therapyMorphine equivalent daily doseVHA health care systemClinical programsImplementation facilitation strategyOutpatient opioid prescriptionsOpioid prescribing practicesPain management servicesCollaborative care programEquivalent daily dosePrimary care clinicsPrimary care providersRE-AIM frameworkInterrupted time seriesOpioid overdose crisisHealth care systemInterrupted time series designEligible patientsMedication taperingOpioid therapyRelationships Between Temporomandibular Disorders, MSD Conditions, and Mental Health Comorbidities: Findings from the Veterans Musculoskeletal Disorders Cohort
Fenton BT, Goulet JL, Bair MJ, Cowley T, Kerns RD. Relationships Between Temporomandibular Disorders, MSD Conditions, and Mental Health Comorbidities: Findings from the Veterans Musculoskeletal Disorders Cohort. Pain Medicine 2018, 19: s61-s68. PMID: 30203016, DOI: 10.1093/pm/pny145.Peer-Reviewed Original ResearchConceptsMental health comorbiditiesTemporomandibular disordersRace/ethnicityHealth comorbiditiesTMD casesAssociation of TMDNational Veterans Health AdministrationNonwhite race/ethnicityNontraumatic joint disordersChronic painful conditionsVeterans Health AdministrationChi-square testCross-sectional analysisObservational cohortBack painPainful conditionsJoint disordersComorbidity patternsMood disordersHispanic ethnicityHispanic womenMale veteransComorbiditiesHealth AdministrationDisorder cohortProject 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 practices
2017
Nationwide Implementation and Outcomes of Cognitive Behavioral Therapy for Chronic Pain Over Clinical Video Teleconferencing
Connolly K, Vanderploeg P, Kerns R, Grant C, Sellinger J, Godleski L. Nationwide Implementation and Outcomes of Cognitive Behavioral Therapy for Chronic Pain Over Clinical Video Teleconferencing. Journal Of Technology In Behavioral Science 2017, 3: 26-31. DOI: 10.1007/s41347-017-0024-4.Peer-Reviewed Original ResearchClinical video teleconferencingVeterans Health AdministrationChronic painCognitive behavioral therapyCBT-CPBehavioral therapyElectronic medical recordsElectronic medical record systemMedical record systemPain intensityPain diagnosisCapitated payment systemMedical recordsTreatment appointmentsTherapy appointmentsDaily livingHealth AdministrationStudy reporting resultsPainTelehealth servicesTelehealth technologyLicensure restrictionsSample t-testNationwide implementationHealthcare systemCare 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 facilityPatientsEpilepsyAdministrationExamining Gender as a Correlate of Self-Reported Pain Treatment Use Among Recent Service Veterans with Deployment-Related Musculoskeletal Disorders
Driscoll MA, Higgins D, Shamaskin-Garroway A, Burger A, Buta E, Goulet JL, Heapy A, Kerns RD, Brandt CA, Haskell SG. Examining Gender as a Correlate of Self-Reported Pain Treatment Use Among Recent Service Veterans with Deployment-Related Musculoskeletal Disorders. Pain Medicine 2017, 18: 1767-1777. PMID: 28379576, DOI: 10.1093/pm/pnx023.Peer-Reviewed Original ResearchConceptsPain treatment modalitiesChronic painSelf-reported useCIH servicesPain treatmentPain careMusculoskeletal conditionsTreatment modalitiesRehabilitation therapyIntegrative health servicesInterventional pain treatmentsChronic pain treatmentWomen Veterans Cohort StudyVeterans Health AdministrationMental health conditionsSelf-rated healthGender differencesSample of veteransCorrelates of SelfCohort studyPain severityCare utilizationSpecialty careTreatment useInterventional strategiesImpact 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
The musculoskeletal diagnosis cohort
Goulet JL, Kerns RD, Bair M, Becker W, Brennan P, Burgess DJ, Carroll CM, Dobscha S, Driscoll M, Fenton BT, Fraenkel L, Haskell S, Heapy A, Higgins D, Hoff RA, Hwang U, Justice AC, Piette JD, Sinnott P, Wandner L, Womack J, Brandt CA. The musculoskeletal diagnosis cohort. Pain 2016, 157: 1696-1703. PMID: 27023420, PMCID: PMC4949131, DOI: 10.1097/j.pain.0000000000000567.Peer-Reviewed Original ResearchConceptsMSD diagnosisMusculoskeletal disordersMSD cohortIndex dateVeterans Health Administration (VHA) careNumeric rating scale scoreICD-9-CM codesCohort inclusion criteriaNontraumatic joint disordersPain-related treatmentsMore outpatient visitsVeterans Health AdministrationMental health diagnosesRating Scale scoresHigher NRS scoresHealth services researchElectronic health recordsDiagnosis cohortSevere painInpatient visitsNRS scoresOutpatient visitsNeck disordersFirst diagnosisMean ageImplementation of telementoring for pain management in Veterans Health Administration: Spatial analysis
Carey EP, Frank JW, Kerns RD, Ho PM, Kirsh SR. Implementation of telementoring for pain management in Veterans Health Administration: Spatial analysis. The Journal Of Rehabilitation Research And Development 2016, 53: 147-156. PMID: 26934696, DOI: 10.1682/jrrd.2014.10.0247.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationProportion of veteransPain managementSCAN-ECHOSpecialty Care Access Network-ExtensionHealth AdministrationPrimary care provider participationPain specialty clinicPrimary care providersSpecialty care clinicsCommunity Healthcare OutcomesLow spatial accessCare clinicsChronic painHealthcare networkPain careGroup of hospitalsSpecialty clinicVHA sitesCare providersVeterans HomeLogistic regressionHealthcare outcomesClinicProvider participation
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 diagnosisPainAntidepressantsOpioidsEvaluation 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 consultationPrevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration
Barry DT, Sofuoglu M, Kerns RD, Wiechers IR, Rosenheck RA. Prevalence and correlates of co-prescribing psychotropic medications with long-term opioid use nationally in the Veterans Health Administration. Psychiatry Research 2015, 227: 324-332. PMID: 25863822, DOI: 10.1016/j.psychres.2015.03.006.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-Anxiety AgentsAntidepressive AgentsDrug PrescriptionsFemaleHumansHypnotics and SedativesMaleMental DisordersOpioid-Related DisordersPrevalencePsychotropic DrugsSleep Initiation and Maintenance DisordersUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsMental health clinicsPsychotropic medicationsOpioid prescriptionsHealth clinicsMedical indicationsAnxiolytics/sedatives/hypnoticsLong-term opioid useSpecialty mental health clinicsService use correlatesRelated adverse eventsSedative/hypnoticsVeterans Health AdministrationMental health treatmentAdverse eventsOpioid useHarmful side effectsFiscal year 2012More psychotropicsSide effectsPsychiatric diagnosisHealth treatmentMedicationsHealth AdministrationPsychotropicsAnxiety disorders