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 disorderRisk Factors Associated with Healthcare Utilization for Spine Pain
Higgins DM, Han L, Kerns RD, Driscoll MA, Heapy AA, Skanderson M, Lisi AJ, Mattocks KM, Brandt C, Haskell SG. Risk Factors Associated with Healthcare Utilization for Spine Pain. Pain Medicine 2022, 23: 1423-1433. PMID: 34999899, DOI: 10.1093/pm/pnab351.Peer-Reviewed Original ResearchConceptsSpine pain careSpine painHealthcare utilizationPain careRisk factorsPain episodesObservation periodNew episodesMultivariable logistic regression modelPotential risk factorsOutpatient visit dataLogistic regression analysisMental health conditionsBaseline observation periodLogistic regression modelsBaseline characteristicsOutpatient visitsClinical correlatesContinued careLower oddsPainVisit dataContinued episodesHealth conditionsCareArtificial Intelligence (AI) to improve chronic pain care: Evidence of AI learning
Piette J, Newman S, Krein S, Marinec N, Chen J, Williams D, Edmond S, Driscoll M, LaChappelle K, Maly M, Kim H, Farris K, Higgins D, Kerns R, Heapy A. Artificial Intelligence (AI) to improve chronic pain care: Evidence of AI learning. Intelligence-Based Medicine 2022, 6: 100064. DOI: 10.1016/j.ibmed.2022.100064.Peer-Reviewed Original ResearchPatient interactionsPatient subgroupsInteractive voice response callsPain-related interferenceComparative effectiveness trialChronic pain careCourse of therapyPedometer step countsDisease management programsCognitive behavioral therapyCBT-CPChronic painMore patientsPain careTreatment modalitiesTreatment recommendationsEffectiveness trialPatientsStep countBehavioral therapyClinician timeWeeksTherapy sessionsMethods DataTherapist feedback
2021
Measuring pain care quality in the Veterans Health Administration primary care setting
Luther SL, Finch DK, Bouayad L, McCart J, Han L, Dobscha SK, Skanderson M, Fodeh SJ, Hahm B, Lee A, Goulet JL, Brandt CA, Kerns RD. Measuring pain care quality in the Veterans Health Administration primary care setting. Pain 2021, 163: e715-e724. PMID: 34724683, PMCID: PMC8920945, DOI: 10.1097/j.pain.0000000000002477.Peer-Reviewed Original ResearchConceptsPain care qualityPattern of documentationSevere pain intensityFrequency of documentationPresence of painSite of painPrimary care providersPrimary care settingCare quality indicatorsQuality improvement initiativesTotal PCQ scoresPatient characteristicsPain intensityPain carePain impactPCQ scoresCare settingsCare providersMusculoskeletal disordersFurther evaluationPainCare qualityHealthcare facilitiesImprovement initiativesUnique visitsCorrelates of Manual Therapy and Acupuncture Use Among Rural Patients Seeking Conventional Pain Management: A Cross-sectional Study
Feinberg TM, Coleman B, Innes KE, Kerns RD, Jackson B, Lisi A, Majoris N, Brandt C. Correlates of Manual Therapy and Acupuncture Use Among Rural Patients Seeking Conventional Pain Management: A Cross-sectional Study. Journal Of Manipulative And Physiological Therapeutics 2021, 44: 330-343. PMID: 33896602, DOI: 10.1016/j.jmpt.2021.01.002.Peer-Reviewed Original ResearchConceptsComplementary health approachesManual therapyCross-sectional studyPain managementAcupuncture useHealth approachAge-adjusted logistic regressionConventional pain managementCurrent chronic painHigh pain burdenPrior opioid usePain scale scoresMind-body therapiesHealth-related factorsPain-related distressPain burdenOpioid useRheumatology clinicChronic painClinical outcomesPain carePain distressRural patientsMajority of participantsPrescription medications
2020
Predictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain
Solar C, Halat AM, MacLean RR, Rajeevan H, Williams DA, Krein SL, Heapy AA, Bair MJ, Kerns RD, Higgins DM. Predictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain. Translational Behavioral Medicine 2020, 11: 1274-1282. PMID: 33098304, DOI: 10.1093/tbm/ibaa098.Peer-Reviewed Original ResearchConceptsChronic low back painLow back painClinical characteristicsBack painChronic painEASE programParticipant characteristicsInternet-based cognitive behavioural therapy programmeInternet-based cognitive behavioral therapy interventionInternet-based interventionsCognitive behavioral therapy interventionInternet-based programCognitive behavioral therapy programBehavioral therapy interventionBehavioral therapy programRace/ethnicityPain careMean ageNumber of loginsIncreased ageTherapy interventionWeek trialPainTherapy programPredictors of engagement
2019
Core Competencies for the Emerging Specialty of Pain Psychology
Wandner LD, Prasad R, Ramezani A, Malcore SA, Kerns RD. Core Competencies for the Emerging Specialty of Pain Psychology. American Psychologist 2019, 74: 432-444. PMID: 30070541, DOI: 10.1037/amp0000330.Peer-Reviewed Original ResearchConceptsNational Pain StrategyPain managementInstitute of MedicinePain psychologistPain strategiesChronic painPain carePain psychologyPainField of psychologyIOM reportCore competenciesSpecialty areasPsychologistsHuman ServicesPivotal rolePsychologyMultiple professionsEmerging SpecialtySpecialtiesCurrent articleManagementCliniciansCare
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 practicesAssociation Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy
Carey EP, Nolan C, Kerns RD, Ho PM, Frank JW. Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy. Journal Of General Internal Medicine 2018, 33: 38-45. PMID: 29633137, PMCID: PMC5902343, DOI: 10.1007/s11606-018-4324-y.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyNon-pharmacologic treatmentsFacility-level variationNon-opioid medicationsChronic painOpioid therapyTreatment modalitiesVeterans Health Administration facilitiesPatient-reported painChronic pain treatmentChronic pain careImproved patient outcomesUtilization patternsOpioid treatmentPrior calendar yearMedication utilizationPatient characteristicsPain treatmentPain careKey ResultsAmongPrimary carePatient outcomesPainGreater utilizationAdministration facilitiesVeteran Experiences Seeking Non-pharmacologic Approaches for Pain
Giannitrapani K, McCaa M, Haverfield M, Kerns RD, Timko C, Dobscha S, Lorenz K. Veteran Experiences Seeking Non-pharmacologic Approaches for Pain. Military Medicine 2018, 183: e628-e634. PMID: 29590422, DOI: 10.1093/milmed/usy018.Peer-Reviewed Original ResearchConceptsNon-pharmacologic approachesUS military veteransPatient-centered pain careVA health care systemManagement of painNumeric rating scalePrimary care clinicsMilitary veteransPain intensity ratingsSpecific access barriersVA healthcare systemMulti-level barriersHealth care systemVeterans' experiencesFuture implementation effortsPain screeningCare clinicsPain carePrimary careCare coordinationPain studiesPainPain experienceVeterans' knowledgeFemale veterans
2017
Examining 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 strategies
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 carePatient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools: Protocol for a Randomized Study Funded by the US Department of Veterans Affairs Health Services Research and Development Program
Piette JD, Krein SL, Striplin D, Marinec N, Kerns RD, Farris KB, Singh S, An L, Heapy AA. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools: Protocol for a Randomized Study Funded by the US Department of Veterans Affairs Health Services Research and Development Program. JMIR Research Protocols 2016, 5: e53. PMID: 27056770, PMCID: PMC4856067, DOI: 10.2196/resprot.4995.Peer-Reviewed Original ResearchInteractive voice response callsTelephone Cognitive Behavioral TherapyChronic low back painCognitive behavioral therapyPain management servicesLow back painBack painTreatment responsePatient-centered pain carePedometer-measured step countsStep countVeterans Affairs Health Services ResearchVeterans Affairs patientsPain-related interferencePain-related outcomesPain-related functioningVA healthcare systemMobile health toolsWeekly hour-long sessionsPedometer step countsSignificant treatment responseHealth services researchPain controlTreatment satisfactionPain careStepped 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 ResearchImplementation 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
Evaluation 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 consultation
2014
A 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 careDevelopment and application of an electronic health record information extraction tool to assess quality of pain management in primary care
Dorflinger LM, Gilliam WP, Lee AW, Kerns RD. Development and application of an electronic health record information extraction tool to assess quality of pain management in primary care. Translational Behavioral Medicine 2014, 4: 184-189. PMID: 24904702, PMCID: PMC4041928, DOI: 10.1007/s13142-014-0260-5.Peer-Reviewed Original ResearchPrimary care settingPain managementChronic painPain carePrimary careCare settingsGuideline-concordant carePrimary care providersCommon presenting problemPain expertsInter-rater reliabilityCare providersCarePresenting problemInterdisciplinary panelPainFinal toolPilot testingPresence of indicatorsSettingExtraction toolQuality indicators
2013
Agreement Between Electronic Medical Record-based and Self-administered Pain Numeric Rating Scale
Goulet JL, Brandt C, Crystal S, Fiellin DA, Gibert C, Gordon AJ, Kerns RD, Maisto S, Justice AC. Agreement Between Electronic Medical Record-based and Self-administered Pain Numeric Rating Scale. Medical Care 2013, 51: 245-250. PMID: 23222528, PMCID: PMC3572341, DOI: 10.1097/mlr.0b013e318277f1ad.Peer-Reviewed Original ResearchConceptsNumeric rating scaleElectronic medical recordsPain screeningMedical recordsPain numeric rating scaleRating ScaleModerate-severe painVeterans Affairs medical facilitiesPatients' electronic medical recordsMajor depressive disorderEMR dataQuality of careUnderestimation of painSample of veteransPosttraumatic stress disorderHealth care systemClinical characteristicsPatient characteristicsNRS scoresPain careDepressive disorderSurvey scoresPainLevel of agreementStress disorder
2011
Implementation of the Veterans Health Administration National Pain Management Strategy
Kerns RD, Philip EJ, Lee AW, Rosenberger PH. Implementation of the Veterans Health Administration National Pain Management Strategy. Translational Behavioral Medicine 2011, 1: 635-643. PMID: 24073088, PMCID: PMC3717675, DOI: 10.1007/s13142-011-0094-3.Peer-Reviewed Original Research