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 ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidBaltimoreCommunity Health ServicesDistrict of ColumbiaFemaleGuideline AdherenceHumansMaleMiddle AgedOpioid-Related DisordersPractice Guidelines as TopicUnited StatesUnited States Department of Veterans AffairsVeteransVeterans Health ServicesConceptsDual-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
2023
Fall-related Injuries and Opioid Administration Among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers
Wang H, Cai S, Caprio T, Goulet J, Intrator O. Fall-related Injuries and Opioid Administration Among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers. Medical Care 2023, 61: 579-586. PMID: 37476853, DOI: 10.1097/mlr.0000000000001889.Peer-Reviewed Original ResearchMeSH KeywordsAgedAlzheimer DiseaseAnalgesics, OpioidHumansMedicare Part DPractice Patterns, Physicians'Retrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsFall-related injuriesOpioid Safety InitiativeOpioid administrationCLC residentsVeterans Affairs Community Living CentersAlzheimer's diseasePropensity scoreSafety initiativesMinimum Data Set assessmentsMedication administration dataOpioid use reductionPrescription refill dataCommunity Living CentersMedicare Part D dataNursing home residentsLong-stay residentsPart D dataNonopioid usersOpioid useRefill dataUntreated painHome residentsVA CLCsAdjusted probabilityCare recordsGraded chronic pain scale revised: validation in a Veteran sample
Taub C, Gordon K, Goulet J, Lee A, Mayhew M, Von Korff M, DeBar L, Kerns R. Graded chronic pain scale revised: validation in a Veteran sample. Pain Medicine 2023, 24: 1169-1175. PMID: 37220899, PMCID: PMC10546477, DOI: 10.1093/pm/pnad068.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidChronic PainHumansPain MeasurementSurveys and QuestionnairesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsGraded Chronic Pain ScaleHigh-impact chronic painAdjusted odds ratioMild chronic painChronic Pain ScaleChronic painPain scaleConfidence intervalsLong-term opioid therapyHigh-risk populationOpioid therapyPain gradeUS veteransOdds ratioActivity limitationsPainPain researchLogistic regressionVeteran sampleHealth indicatorsStudy objectiveConvergent validityValidation studyVeteransPsychological variablesOpioid use and opioid use disorder in mono and dual-system users of veteran affairs medical centers
Goulet J, Cheng Y, Becker W, Brandt C, Sandbrink F, Workman T, Ma P, Libin A, Shara N, Spevak C, Kupersmith J, Zeng-Treitler Q. Opioid use and opioid use disorder in mono and dual-system users of veteran affairs medical centers. Frontiers In Public Health 2023, 11: 1148189. PMID: 37124766, PMCID: PMC10141670, DOI: 10.3389/fpubh.2023.1148189.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidFemaleHumansMaleOpioid-Related DisordersRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsOpioid use disorderNew opioid prescriptionsOpioid prescriptionsOUD diagnosisVA careUse disordersPrevalence of OUDVeterans Affairs Medical CenterGuideline-concordant careRetrospective cohort studyMultivariate logistic regressionNon-VA sourcesVeterans Administration dataCommunity care servicesPrescription sourceUS healthcare systemOpioid medicationsOpioid useCohort studyConcordant careActive patientsVA cliniciansIntra-class correlationMedical CenterWhite raceTrends in Risk-Adjusted Initiation and Reduction of Opioid Use among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers
Wang H, Cai S, Caprio T, Goulet J, Intrator O. Trends in Risk-Adjusted Initiation and Reduction of Opioid Use among Veterans With Dementia in US Department of Veterans Affairs Community Living Centers. Journal Of The American Medical Directors Association 2023, 24: 1061-1067.e4. PMID: 36963437, DOI: 10.1016/j.jamda.2023.02.015.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesChronic PainDementiaHumansOpioid-Related DisordersRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsCommunity Living CentersAdministration dayOpioid cohortMinimum Data SetOpioid administrationGuideline periodVeterans Affairs Community Living CentersLiving CentersMedication administration dataReduction of opioidsSafe pain reliefNursing home residentsFacility-level characteristicsHealth care professionalsVA Central OfficeQuality of careOpioid initiationOpioid dosageNonpharmacologic treatmentsOpioid usePain reliefOpioid misuseRetrospective studyCLC residentsBenzodiazepine administration
2022
Joint longitudinal trajectories of pain intensity and opioid prescription in veterans with back pain
Buta E, Gordon KS, Gueorguieva R, Becker WC, Heapy A, Bathulapalli H, Zeng Q, Redd D, Brandt C, Goulet J. Joint longitudinal trajectories of pain intensity and opioid prescription in veterans with back pain. Pharmacoepidemiology And Drug Safety 2022, 31: 1262-1271. PMID: 35996825, DOI: 10.1002/pds.5531.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBack PainHumansMiddle AgedPain MeasurementPrescriptionsRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsBack painOpioid prescriptionsPain/Pain intensityRetrospective cohort studyTrajectories of painElectronic health record dataMental health diagnosesHealth record dataHigh opioidCohort studyClinical predictorsHigher oddsPainLatent class growth analysisOpioidsPain classesHealth diagnosisRecord dataVeteransLongitudinal trajectoriesPrescriptionOddsTrajectory classesDistinct patternsMental 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 ResearchMeSH KeywordsChronic PainElectronic Health RecordsHumansMental HealthPrimary Health CareQuality of Health CareRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsPain 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 disorderOpioid administration trends among long‐stay community living centers residents with dementia
Wang H, Cai S, Caprio T, Goulet J, Intrator O. Opioid administration trends among long‐stay community living centers residents with dementia. Journal Of The American Geriatrics Society 2022, 70: 2393-2403. PMID: 35397116, DOI: 10.1111/jgs.17785.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesDementiaHumansUnited StatesUnited States Department of Veterans AffairsVeteransConceptsCommunity Living CentersOpioid administrationLong-term opioid administrationPopulation-based observational studyHigh-dose opioidsMedication administration dataLong-term opioidsVA health systemMinimum Data Set dataTreatment of painLength of stayPatient-level covariatesManagement of veteransOpioid medicationsPain assessmentObservational studyOpioidsHealth outcomesAlzheimer's diseaseRelated dementiaNegative binomial regressionHealth systemFiscal year 2013Living CentersAdministration
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 ResearchMeSH KeywordsHumansPainPrimary Health CareQuality of Health CareReproducibility of ResultsUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsPain 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 visitsMilitary 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 ResearchMeSH KeywordsFemaleHumansIraq War, 2003-2011MaleMental HealthMilitary PersonnelSex OffensesSexual TraumaStress Disorders, Post-TraumaticSuicidal IdeationUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsMental 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 survivorsWomenDiagnosisTraumaVeteransExamining Health Care Mobility of Transgender Veterans Across the Veterans Health Administration
Wang KH, McAvay G, Warren A, Miller ML, Pho A, Blosnich JR, Brandt CA, Goulet JL. Examining Health Care Mobility of Transgender Veterans Across the Veterans Health Administration. LGBT Health 2021, 8: 143-151. PMID: 33512276, PMCID: PMC8098769, DOI: 10.1089/lgbt.2020.0152.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedCohort StudiesElectronic Health RecordsFemaleHumansMaleMiddle AgedPatient Acceptance of Health CareTransgender PersonsTravelUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthVeterans Health ServicesYoung AdultConceptsVeterans Health AdministrationPost-traumatic stress disorderHealth care systemTransgender veteransCare systemHealth AdministrationComplex chronic health conditionsVHA electronic health recordsConditional logistic regression modelsChronic health conditionsDiagnosis of depressionDifferent health care systemsHealth care servicesLogistic regression modelsElectronic health recordsHepatitis CMultidisciplinary careCare coordinationDepressive disorderMultivariable modelGeneral populationCare servicesOlder ageStress disorderHealth conditions
2020
Sex Differences in Military Sexual Trauma and Severe Self-Directed Violence
Gross GM, Ronzitti S, Combellick JL, Decker SE, Mattocks KM, Hoff RA, Haskell SG, Brandt CA, Goulet JL. Sex Differences in Military Sexual Trauma and Severe Self-Directed Violence. American Journal Of Preventive Medicine 2020, 58: 675-682. PMID: 32037020, DOI: 10.1016/j.amepre.2019.12.006.Peer-Reviewed Original ResearchMeSH KeywordsAdultFemaleHumansMaleMilitary PersonnelSex FactorsSex OffensesSexual HarassmentSexual TraumaSuicide, AttemptedUnited StatesUnited States Department of Veterans AffairsViolenceConceptsMilitary sexual traumaSelf-directed violenceSexual traumaWomen veteransCox proportional hazards regression modelVeterans Health Administration (VHA) careProportional hazards regression modelsHazards regression modelsOperations Enduring Freedom/Iraqi Freedom/New Dawn veteransPsychiatric morbidityNew Dawn veteransSuicide attemptsBivariate analysisPreventative effortsTraumaWomenMenSex differencesVeteransRiskRegression modelsDemographic variablesSevere selfHospitalizationMorbidity
2019
Screening for Military Sexual Trauma Is Associated With Improved HIV Screening in Women Veterans
Reddy SM, Portnoy GA, Bathulapalli H, Womack J, Haskell SG, Mattocks K, Brandt CA, Goulet JL. Screening for Military Sexual Trauma Is Associated With Improved HIV Screening in Women Veterans. Medical Care 2019, 57: 536-543. PMID: 31194701, DOI: 10.1097/mlr.0000000000001130.Peer-Reviewed Original ResearchMeSH KeywordsAdultCross-Sectional StudiesFemaleHIV InfectionsHumansLongitudinal StudiesMass ScreeningMilitary PersonnelSex OffensesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsMilitary sexual traumaWomen veteransCohort studyComprehensive preventive health careVeterans AffairsSexual traumaOdds of HIVPositive MST screenHIV risk factorsWomen Veterans Cohort StudyHealth careCross-sectional studyMental health diagnosesPreventive health careFacility-level clusteringHistory of MSTMST screenHIV screeningMultivariable analysisHIV screenRisk factorsHIVHealth diagnosisBivariate statisticsDemographic characteristics
2018
Dual Use of Department of Veterans Affairs and Medicare Benefits on High‐Risk Opioid Prescriptions in Veterans Aged 65 Years and Older: Insights from the VA Musculoskeletal Disorders Cohort
Chui PW, Bastian LA, DeRycke E, Brandt CA, Becker WC, Goulet JL. Dual Use of Department of Veterans Affairs and Medicare Benefits on High‐Risk Opioid Prescriptions in Veterans Aged 65 Years and Older: Insights from the VA Musculoskeletal Disorders Cohort. Health Services Research 2018, 53: 5402-5418. PMID: 30298672, PMCID: PMC6235820, DOI: 10.1111/1475-6773.13060.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAnalgesics, OpioidComorbidityCross-Sectional StudiesFemaleHumansInsurance Claim ReviewMaleMedicareMusculoskeletal DiseasesRacial GroupsRetrospective StudiesSeverity of Illness IndexSex FactorsUnited StatesUnited States Department of Veterans AffairsConceptsVeterans Health AdministrationOpioid prescriptionsHigh-risk opioid prescriptionsLong-term opioid therapyLong-term opioid useMultivariable logistic regressionMusculoskeletal disorder diagnosisMSD cohortOpioid therapyClinical characteristicsOpioid useVHA dataRetrospective analysisHealth AdministrationNational MedicareDisorder cohortDual useLogistic regressionDisorder diagnosisMedicareMedicare benefitsVeteransPrescriptionCohortAssociationProject 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 ResearchMeSH KeywordsAgedAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalCohort StudiesDelivery of Health Care, IntegratedFemaleHumansMaleMiddle AgedPainPain ManagementUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthConceptsVA 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 practicesOpioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care
Lisi AJ, Corcoran KL, DeRycke EC, Bastian LA, Becker WC, Edmond SN, Goertz CM, Goulet JL, Haskell SG, Higgins DM, Kawecki T, Kerns RD, Mattocks K, Ramsey C, Ruser CB, Brandt CA. Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care. Pain Medicine 2018, 19: s54-s60. PMID: 30203014, DOI: 10.1093/pm/pny114.Peer-Reviewed Original ResearchMeSH KeywordsAdultAfghan Campaign 2001-Analgesics, OpioidCross-Sectional StudiesDrug PrescriptionsFemaleHumansIraq War, 2003-2011MaleManipulation, ChiropracticMiddle AgedOpioid-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsOEF/OIF/OND veteransOpioid prescriptionsChiropractic visitsOpioid useChiropractic careOperations Enduring Freedom/Iraqi Freedom/New DawnMore opioid prescriptionsVA chiropractic servicesPercentage of veteransCross-sectional analysisOpioid receiptClinic visitsClinical characteristicsCurrent smokingSevere painChiropractic clinicChiropractic servicesVisitsHigher likelihoodVeteransPrescriptionCareFurther studiesAdministrative dataOne-third
2017
Opioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts
Han L, Allore H, Goulet J, Bathulapali H, Skanderson M, Brandt C, Haskell S, Krebs E. Opioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts. Annals Of Epidemiology 2017, 27: 563-569.e3. PMID: 28890282, PMCID: PMC5647654, DOI: 10.1016/j.annepidem.2017.08.015.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidChronic PainDrug PrescriptionsElectronic PrescribingFemaleHumansMaleMental HealthMiddle AgedMusculoskeletal DiseasesOpioid-Related DisordersPrescription DrugsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthYoung AdultConceptsHigh-dose prescribingOpioid prescriptionsMental health diagnosesMusculoskeletal disordersDaily morphine equivalentsHealth diagnosisHigh-dose therapyLong-term opioidsHigh-dose prescriptionsAverage daily dosePosttraumatic stress disorderMorphine equivalentsDose therapyDaily dosePatient characteristicsChronic painUS veteransOdds ratioPrescribingStress disorderBaseline periodGeographic confoundingVeteransPrescriptionOpioidsRacial and Ethnic Differences in Total Knee Arthroplasty in the Veterans Affairs Health Care System, 2001–2013
Hausmann LRM, Brandt CA, Carroll CM, Fenton BT, Ibrahim SA, Becker WC, Burgess DJ, Wandner LD, Bair MJ, Goulet JL. Racial and Ethnic Differences in Total Knee Arthroplasty in the Veterans Affairs Health Care System, 2001–2013. Arthritis Care & Research 2017, 69: 1171-1178. PMID: 27788302, PMCID: PMC5538734, DOI: 10.1002/acr.23137.Peer-Reviewed Original ResearchMeSH KeywordsAgedArthroplasty, Replacement, KneeBlack PeopleCohort StudiesElectronic Health RecordsEthnicityFemaleHispanic or LatinoHumansMaleMiddle AgedRacial GroupsUnited StatesUnited States Department of Veterans AffairsVeteransWhite PeopleConceptsTotal knee arthroplastyKnee arthroplastyOA diagnosisHispanic-white differencesHispanic veteransVeterans Affairs Health Care SystemTotal knee arthroplasty (TKA) rateCox proportional hazards regressionTotal knee arthroplasty proceduresIncreased clinical severityKnee arthroplasty ratesPotential clinical confoundersPain intensity scoresProportional hazards regressionBody mass indexKnee arthroplasty proceduresEthnic differencesMusculoskeletal disorder diagnosisHealth care systemElectronic health recordsClinical confoundersHazards regressionMass indexRheumatology specialistsClinical severityMultiple 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 ResearchMeSH KeywordsAdultAgedAged, 80 and overAnalgesics, OpioidCross-Sectional StudiesFemaleHumansInsurance, Health, ReimbursementKentuckyMaleMiddle AgedRisk-TakingUnited StatesUnited States Department of Veterans AffairsVeterans HealthConceptsOpioid 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 sampleOpioidsOddsTrends in diagnosis of painful neck and back conditions, 2002 to 2011
Sinnott PL, Dally SK, Trafton J, Goulet JL, Wagner TH. Trends in diagnosis of painful neck and back conditions, 2002 to 2011. Medicine 2017, 96: e6691. PMID: 28514286, PMCID: PMC5440123, DOI: 10.1097/md.0000000000006691.Peer-Reviewed Original ResearchMeSH KeywordsBack PainComorbidityFemaleHumansIncidenceInternational Classification of DiseasesMaleMiddle AgedNeck PainPrevalenceRetrospective StudiesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsBack painPain problemsPainful neckLarge national healthcare systemRetrospective observational cohort studyEffective care systemNeck pain conditionsObservational cohort studyPrevalence of diagnosesBack conditionsBack pain problemsDiagnosis of neckCohort studyPain conditionsCalendar year 2002Incident casesRevision codesNational cohortNational healthcare systemIncidence ratePrevalent casesPrevalence ratesInternational ClassificationPainAverage duration