2022
Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools
Piette JD, Newman S, Krein SL, Marinec N, Chen J, Williams DA, Edmond SN, Driscoll M, LaChappelle KM, Kerns RD, Maly M, Kim HM, Farris KB, Higgins DM, Buta E, Heapy AA. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools. JAMA Internal Medicine 2022, 182: 975-983. PMID: 35939288, PMCID: PMC9361183, DOI: 10.1001/jamainternmed.2022.3178.Peer-Reviewed Original ResearchConceptsCBT-CPComparative effectiveness trialTherapist timeSecondary outcomesMore patientsEffectiveness trialInteractive voice responseCP groupMeaningful improvementsPatient-centered pain careRoland-Morris Disability QuestionnaireVeterans Affairs Health SystemMorris Disability QuestionnairePain intensity scoresChronic back painLess therapist timeMobile health toolsCognitive behavioral therapyRandomized noninferiorityDisability QuestionnaireNoninferiority criteriaOpioid analgesicsPain intensityPain therapyPrimary outcomeSelf-Reported Cannabis Use and HIV Viral Control among Patients with HIV Engaged in Care: Results from a National Cohort Study
Bahji A, Li Y, Vickers-Smith R, Crystal S, Kerns RD, Gordon KS, Macmadu A, Skanderson M, So-Armah K, Sung ML, Bhondoekhan F, Marshall BDL, Edelman EJ. Self-Reported Cannabis Use and HIV Viral Control among Patients with HIV Engaged in Care: Results from a National Cohort Study. International Journal Of Environmental Research And Public Health 2022, 19: 5649. PMID: 35565045, PMCID: PMC9101884, DOI: 10.3390/ijerph19095649.Peer-Reviewed Original ResearchConceptsDetectable viral loadPast-year cannabis useViral loadAntiretroviral therapyCannabis useCohort studyUnadjusted analysesViral controlDetectable HIV viral loadVeterans Aging Cohort StudyHIV viral controlHIV viral loadAging Cohort StudyFirst study visitHIV-1 RNANational cohort studyBenefits of cannabisSelf-reported cannabis usePast-year useMean ageStudy visitHigher oddsPWHSignificant associationSubstance useAssociation 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 facilitiesRisk 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 conditionsCare
2021
Military sexual trauma and suicidal ideation in VHA-care-seeking OEF/OIF/OND veterans without mental health diagnosis or treatment
Decker SE, Ramsey CM, Ronzitti S, Kerns RD, Driscoll MA, Dziura J, Skanderson M, Bathulapalli H, Brandt CA, Haskell SG, Goulet JL. Military sexual trauma and suicidal ideation in VHA-care-seeking OEF/OIF/OND veterans without mental health diagnosis or treatment. Psychiatry Research 2021, 303: 114089. PMID: 34247061, DOI: 10.1016/j.psychres.2021.114089.Peer-Reviewed Original ResearchConceptsMental health diagnosesMilitary sexual traumaVeterans Healthcare AdministrationSuicidal ideationHealth diagnosisSexual traumaRelative risk estimatesOEF/OIF/OND veteransSample of veteransPost-9/11 veteransSuicide risk factorsMental health concernsClinical remindersRisk factorsRelative riskHigh riskMen veteransMental healthcareHealth concernRisk estimatesMST survivorsWomenDiagnosisTraumaVeteransCorrelates 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 engagementAll-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors
Gordon K, Manhapra A, Crystal S, Dziura J, Edelman E, Skanderson M, Kerns R, Justice A, Tate J, Becker W. All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors. Drug And Alcohol Dependence 2020, 216: 108291. PMID: 33011662, PMCID: PMC7644145, DOI: 10.1016/j.drugalcdep.2020.108291.Peer-Reviewed Original ResearchConceptsMorphine equivalent daily doseCause mortalityLong-term opioid therapyTime-updated Cox regressionStrong dose-response relationshipUnnatural deathsEquivalent daily doseDose-response relationshipOpioid doseOpioid therapyUninfected patientsOpioid useDaily doseCox regressionMortality outcomesTherapy doseHigh doseMale veteransOverdose fatalitiesOverdose mortalityPLWHMortalityHIVPatientsDoseNonsteroidal Anti-inflammatory Drugs vs Cognitive Behavioral Therapy for Arthritis Pain
Fraenkel L, Buta E, Suter L, Dubreuil M, Levy C, Najem C, Brennan M, Corn B, Kerns R, Goulet J. Nonsteroidal Anti-inflammatory Drugs vs Cognitive Behavioral Therapy for Arthritis Pain. JAMA Internal Medicine 2020, 180: 1194-1202. PMID: 32702101, PMCID: PMC7372512, DOI: 10.1001/jamainternmed.2020.2821.Peer-Reviewed Original ResearchConceptsNonsteroidal anti-inflammatory drugsWOMAC pain scorePain scoresAnti-inflammatory drugsGlobal ImpressionKnee osteoarthritisMeloxicam groupMcMaster Universities Osteoarthritis Index (WOMAC) pain scoreCurrent nonsteroidal anti-inflammatory drugsLong-term clinical benefitMean differencePain score differenceParticipant global impressionWOMAC disability scoresKnee osteoarthritis painLower extremity disabilityPrimary outcome measureSignificant differencesCognitive behavioral therapy programCognitive behavioral therapyBehavioral therapy programBaseline painOsteoarthritis painTreat basisDisability scoresNeuropsychological 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 disordersTrajectories 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 regressionAre we missing opioid-related deaths among people with HIV?
Becker WC, Gordon KS, Edelman EJ, Goulet JL, Kerns RD, Marshall BDL, Fiellin DA, Justice AC, Tate JP. Are we missing opioid-related deaths among people with HIV? Drug And Alcohol Dependence 2020, 212: 108003. PMID: 32417360, PMCID: PMC9580216, DOI: 10.1016/j.drugalcdep.2020.108003.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyOpioid useOverdose deathsLife-limiting conditionsUnnatural deathsGreater oddsAging Cohort StudyVACS IndexOpioid exposureCohort studyHIV infectionHIV statusRisk factorsOdds ratioDeath filesIndex causeHIVDisease severityDeathDecedentsIllicit useDifferential misclassificationOddsCauseOpioidsThe 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 2Internet‐Based Pain Self‐Management for Veterans: Feasibility and Preliminary Efficacy of the Pain EASE Program
Higgins DM, Buta E, Williams DA, Halat A, Bair MJ, Heapy AA, Krein SL, Rajeevan H, Rosen MI, Kerns RD. Internet‐Based Pain Self‐Management for Veterans: Feasibility and Preliminary Efficacy of the Pain EASE Program. Pain Practice 2020, 20: 357-370. PMID: 31778281, DOI: 10.1111/papr.12861.Peer-Reviewed Original ResearchConceptsChronic low back painSelf-management programPain interferencePreliminary efficacyInternet-based self-management programPhase IPost-baseline assessmentLow back painPain Self-ManagementPhase IIPreliminary efficacy studyTechnology-delivered interventionsModerate painSecondary outcomesPain intensityBack painAverage ageEfficacy studiesDepression symptomsSubject improvementExpert panelSelf-ManagementSubject changesEASE programWeeks
2019
Pain-related illness intrusiveness is associated with lower activity engagement among persons with multiple sclerosis
Gromisch ES, Kerns RD, Beauvais J. Pain-related illness intrusiveness is associated with lower activity engagement among persons with multiple sclerosis. Multiple Sclerosis And Related Disorders 2019, 38: 101882. PMID: 31812040, DOI: 10.1016/j.msard.2019.101882.Peer-Reviewed Original ResearchConceptsWest Haven-Yale Multidimensional Pain InventoryIllness Intrusiveness Ratings ScaleIllness intrusivenessMultiple sclerosisPain experienceActivity engagementNorth American Research CommitteeLeast mild painMultidimensional Pain InventoryLower activity engagementDepression symptom severityMild painPain InventoryChronic painExploratory mediation analysisPainSymptom severityDaily functioningRating ScalePositive coping strategiesSignificant predictorsSclerosisResearch CommitteeMediation analysisCovariatesGraded chronic pain scale revised: mild, bothersome, and high-impact chronic pain.
Von Korff M, DeBar LL, Krebs EE, Kerns RD, Deyo RA, Keefe FJ. Graded chronic pain scale revised: mild, bothersome, and high-impact chronic pain. Pain 2019, 161: 651-661. PMID: 31764390, PMCID: PMC7097879, DOI: 10.1097/j.pain.0000000000001758.Peer-Reviewed Original ResearchConceptsHigh-impact chronic painMild chronic painChronic Pain ScaleGraded Chronic Pain ScaleChronic painPain Scale-RevisedPain scaleLong-term opioid therapySubstantial activity limitationsHealth status indicatorsOpioid therapyAdult enrolleesActivity limitationsPainPain metricsHealth plansNonsignificant differenceStatus indicatorsPersonsValid methodTherapyPrevalenceBothersomeEnrolleesHigh-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 veteransFurther Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients
Mun CJ, Otis JD, Concato J, Reid MC, Burg MM, Czlapinski R, Kerns RD. Further Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients. The Clinical Journal Of Pain 2019, 35: 744-752. PMID: 31149934, DOI: 10.1097/ajp.0000000000000733.Peer-Reviewed Original ResearchConceptsChronic low back pain patientsLow back pain patientsSelf-management approachBack pain patientsCognitive behavioral therapyChronic painDepressive symptom severityPain severityPain patientsPain StagesRegular cognitive behavioural therapySymptom severityVA primary care clinicsChange scoresPrimary care clinicsChange QuestionnaireLong-term functionMaintenance scoresCare clinicsPresent studyPatient readinessPatients' attitudesWeeks posttreatmentSustained benefitTherapeutic mechanismPersonal Resource Profiles of Individuals With Chronic Pain: Sociodemographic and Pain Interference Differences
Mun CJ, Davis MC, Molton IR, Karoly P, Suk HW, Ehde DM, Tennen H, Kerns RD, Jensen MP. Personal Resource Profiles of Individuals With Chronic Pain: Sociodemographic and Pain Interference Differences. Rehabilitation Psychology 2019, 64: 245-262. PMID: 30688480, PMCID: PMC6737933, DOI: 10.1037/rep0000261.Peer-Reviewed Original ResearchConceptsPain interferenceChronic painChronic pain conditionsSubgroup of individualsPain conditionsPain intensityPain acceptanceBaseline differencesSleep qualityDepressive symptomsNeuromuscular diseasePainPersonal resource variablesAnnual income levelSociodemographic differencesDaily diariesImportant associationGroup differencesSubgroupsFibromyalgiaRobust associationSocial supportLatent profile analysisBaselinePresent study