2024
Guideline concordant opioid therapy in Veterans receiving VA and community care
Ma P, Cheng Y, Goulet J, Sandbrink F, Brandt C, Spevak C, Kean J, Becker W, Libin A, Shara N, Sheriff H, Houston J, Butler J, Workman E, Agrawal R, Kupersmith J, Zeng-Treitler Q. Guideline concordant opioid therapy in Veterans receiving VA and community care. BMC Health Services Research 2024, 24: 1284. PMID: 39456008, PMCID: PMC11515256, DOI: 10.1186/s12913-024-11742-1.Peer-Reviewed Original ResearchConceptsDual-system usersGuideline concordant careConcordant careVA servicesCommunity careElectronic health record dataHealth record dataRates of guideline concordanceVA Medical CenterOpioid therapyAdherence to specific guidelinesBaltimore VA Medical CenterGuideline adherenceGuideline concordanceAdherence ratesGuideline recommendationsRecord dataCareDemographic factorsMedical CenterVeteransComorbid conditionsOpioid crisisUrine drug screensSpecific guidelines
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 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 processesBarriers and facilitators to use of non-pharmacological treatments in chronic pain
Becker WC, Dorflinger L, Edmond SN, Islam L, Heapy AA, Fraenkel L. Barriers and facilitators to use of non-pharmacological treatments in chronic pain. BMC Primary Care 2017, 18: 41. PMID: 28320337, PMCID: PMC5359906, DOI: 10.1186/s12875-017-0608-2.Peer-Reviewed Original ResearchConceptsPrimary care providersNominal group techniqueChronic painMean agePain treatment modalitiesProvider-reported barriersNon-pharmacological treatmentPatient-reported barriersChronic pain treatmentPatient-provider interactionsPerspectives of patientsTeam-based approachOpioid therapyPatients' skepticismPain treatmentPatient knowledgeTreatment modalitiesTreatment beliefsModifiable barriersCare providersHealthcare professionalsTreatment philosophyStaff consensusPainPatientsUltra–High-Dose Opioids With Low Efficacy and Significant Harm—Time to Make a Change: A Teachable Moment
Guillod P, Edens EL, Becker WC. Ultra–High-Dose Opioids With Low Efficacy and Significant Harm—Time to Make a Change: A Teachable Moment. JAMA Internal Medicine 2017, 177: 17-18. PMID: 27893881, DOI: 10.1001/jamainternmed.2016.7344.Peer-Reviewed Original Research
2015
Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV
Becker WC, Gordon K, Jennifer Edelman E, Kerns RD, Crystal S, Dziura JD, Fiellin LE, Gordon AJ, Goulet JL, Justice AC, Fiellin DA. Trends in Any and High-Dose Opioid Analgesic Receipt Among Aging Patients With and Without HIV. AIDS And Behavior 2015, 20: 679-686. PMID: 26384973, PMCID: PMC5006945, DOI: 10.1007/s10461-015-1197-5.Peer-Reviewed Original Research
2014
Buprenorphine/Naloxone Dose and Pain Intensity Among Individuals Initiating Treatment for Opioid Use Disorder
Becker WC, Ganoczy D, Fiellin DA, Bohnert AS. Buprenorphine/Naloxone Dose and Pain Intensity Among Individuals Initiating Treatment for Opioid Use Disorder. Journal Of Substance Use And Addiction Treatment 2014, 48: 128-131. PMID: 25312475, DOI: 10.1016/j.jsat.2014.09.007.Peer-Reviewed Original ResearchConceptsOpioid use disorderNumerical rating scoreBUP/NXPain intensityUse disordersPrimary outcomeBuprenorphine/naloxone doseDecreased pain intensityFull agonist opioidsImproved pain intensityBuprenorphine/naloxoneSubset of patientsSubstance use comorbiditiesChronic pain diagnosesPartial agonist propertiesEligible patientsNX treatmentAgonist opioidsPain levelsNaloxone doseComorbid painMultivariable analysisMaintenance treatmentMean ageClinical correlates
2011
Nonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates
Becker WC, Tobin DG, Fiellin DA. Nonmedical Use of Opioid Analgesics Obtained Directly From Physicians: Prevalence and Correlates. JAMA Internal Medicine 2011, 171: 1034-1036. PMID: 21670373, DOI: 10.1001/archinternmed.2011.217.Peer-Reviewed Original ResearchRacial Differences in Primary Care Opioid Risk Reduction Strategies
Becker WC, Starrels JL, Heo M, Li X, Weiner MG, Turner BJ. Racial Differences in Primary Care Opioid Risk Reduction Strategies. The Annals Of Family Medicine 2011, 9: 219-225. PMID: 21555749, PMCID: PMC3090430, DOI: 10.1370/afm.1242.Peer-Reviewed Original ResearchConceptsRegular office visitsUrine drug testingOpioid risk-reduction strategiesWhite patientsBlack patientsOffice visitsRisk reduction strategiesOpioid analgesicsEarly refillsDrug testingGuideline-recommended strategiesOpioids long termChronic noncancer painPrimary care patientsHealth care factorsMixed effects regression modelsRace/ethnicityNoncancer painOpioid refillsMedical comorbiditiesRetrospective cohortCare patientsOpioid misuseCare factorsHigher odds
2010
The Safety of Opioid Analgesics in the Elderly: New Data Raise New Concerns: Comment on “The Comparative Safety of Opioids for Nonmalignant Pain in Older Adults”
Becker WC, O'Connor PG. The Safety of Opioid Analgesics in the Elderly: New Data Raise New Concerns: Comment on “The Comparative Safety of Opioids for Nonmalignant Pain in Older Adults”. JAMA Internal Medicine 2010, 170: 1986-1988. PMID: 21149755, DOI: 10.1001/archinternmed.2010.443.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalCardiovascular DiseasesComorbidityContraindicationsCyclooxygenase 2 InhibitorsDrug UtilizationFemaleFractures, BoneGastrointestinal HemorrhageHumansMaleMedicareObservationPainPain MeasurementResearch DesignTherapeutic EquivalencyUnited States
2009
The Association Between Chronic Pain and Prescription Drug Abuse in Veterans
Becker WC, Fiellin DA, Gallagher RM, Barth KS, Ross JT, Oslin DW. The Association Between Chronic Pain and Prescription Drug Abuse in Veterans. Pain Medicine 2009, 10: 531-536. PMID: 19425211, DOI: 10.1111/j.1526-4637.2009.00584.x.Peer-Reviewed Original ResearchConceptsPrescription drug abuseChronic painIllicit drug useDrug abuseMultivariable analysisPrimary careDrug useBehavioral health evaluationPast-year illicit drug usePrimary care patientsBehavioral health assessmentCross-sectional analysisCurrent smokingCare patientsTreatment algorithmMean agePrescription medicationsProbable depressionMultivariable associationsLarge cohortPossible depressionTelephone assessmentPainPatientsYounger age