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 disorder
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 visits
2020
“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
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 therapyMaking Integrated Multimodal Pain Care a Reality: A Path Forward
Kerns RD, Krebs EE, Atkins D. Making Integrated Multimodal Pain Care a Reality: A Path Forward. Journal Of General Internal Medicine 2018, 33: 1-3. PMID: 29633131, PMCID: PMC5902350, DOI: 10.1007/s11606-018-4361-6.Peer-Reviewed Original Research
2014
Integrating Interdisciplinary Pain Management into Primary Care: Development and Implementation of a Novel Clinical Program
Dorflinger LM, Ruser C, Sellinger J, Edens EL, Kerns RD, Becker WC. Integrating Interdisciplinary Pain Management into Primary Care: Development and Implementation of a Novel Clinical Program. Pain Medicine 2014, 15: 2046-2054. PMID: 25234837, DOI: 10.1111/pme.12554.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Care FacilitiesDelivery of Health CareHumansPain ManagementPatient SatisfactionPrimary Health CareConceptsPrimary careRapid Process Improvement WorkshopCare servicesCommunity-based outpatient clinicsInterdisciplinary pain programPain management resourcesSystems-level gapsInterdisciplinary pain managementVeterans Health AdministrationLarge healthcare systemSystems-based interventionsEvidence of safetyInterprofessional groupStudy-Act approachPain clinicPain managementPain programOutpatient clinicImproved outcomesInterdisciplinary clinicMedical CenterProvider satisfactionHealth AdministrationPDSA cyclesMisuse problemsA 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 careGuideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Weisberg DF, Justice AC, Fiellin DA. Guideline-Concordant Management of Opioid Therapy Among Human Immunodeficiency Virus (HIV)-Infected and Uninfected Veterans. Journal Of Pain 2014, 15: 1130-1140. PMID: 25152300, PMCID: PMC4253900, DOI: 10.1016/j.jpain.2014.08.004.Peer-Reviewed Original ResearchConceptsCurrent substance use disorderGuideline-concordant careOpioid therapyUrine drug testsHuman immunodeficiency virusSubstance use disordersUninfected patientsImmunodeficiency virusUse disordersPatient/provider characteristicsPrimary care provider visitsVeterans Affairs/DepartmentGuideline-concordant managementDrug testsCare concordantGuideline concordanceUninfected veteransProvider visitsPatient characteristicsPatient groupPrimary careClinical guidelinesPain medicineProvider characteristicsPatients
2013
A Research Agenda for Enhancing Appropriate Opioid Prescribing in Primary Care
Becker WC, Fraenkel L, Kerns RD, Fiellin DA. A Research Agenda for Enhancing Appropriate Opioid Prescribing in Primary Care. Journal Of General Internal Medicine 2013, 28: 1364-1367. PMID: 23568187, PMCID: PMC3785661, DOI: 10.1007/s11606-013-2422-4.Peer-Reviewed Educational MaterialsConceptsOpioid prescribingLong-term opioid therapyMulti-modal treatment planAppropriate opioid prescribingOpioid analgesic therapyPatient-reported safetyEvidence-based algorithmOpioid therapyOptimize therapyAnalgesic therapyChronic painPotent medicationsInadequate efficacyPrimary careQuality improvement workPatient sufferingMild toxicityTreatment planScant dataTherapyPrescribingEfficacyPatientsOutcomesToxicity
2008
The Association of Sexual Trauma with Persistent Pain in a Sample of Women Veterans Receiving Primary Care
Haskell SG, Papas RK, Heapy A, Reid MC, Kerns RD. The Association of Sexual Trauma with Persistent Pain in a Sample of Women Veterans Receiving Primary Care. Pain Medicine 2008, 9: 710-717. PMID: 18565005, DOI: 10.1111/j.1526-4637.2008.00460.x.Peer-Reviewed Original ResearchConceptsPain-related interferencePresence of painPersistent painPain intensityWomen veteransClinic populationChronic conditionsHealth centersSexual traumaDepressive symptom severity scoresMultivariate logistic regression analysisOngoing pain problemsMultivariate linear regression analysisMore chronic conditionsGreater pain intensityDepressive symptom scoresSymptom severity scoresWomen's health centersLogistic regression analysisRegression analysisDepression symptom severityHigh rateMilitary sexual harassmentPain interferenceRoutine appointments
2006
The Prevalence and Age-Related Characteristics of Pain in a Sample of Women Veterans Receiving Primary Care
Haskell SG, Heapy A, Reid MC, Papas RK, Kerns RD. The Prevalence and Age-Related Characteristics of Pain in a Sample of Women Veterans Receiving Primary Care. Journal Of Women's Health 2006, 15: 862-869. PMID: 16999642, DOI: 10.1089/jwh.2006.15.862.Peer-Reviewed Original ResearchConceptsWomen veteransPain problemsPrimary careHealth clinicsHealth centersHigh prevalenceVA women’s health clinicAnalgesic medication useOngoing pain problemsPrevalence of painMental health visitsAverage pain intensityCharacteristics of painWomen's health clinicWomen's health centersPain intensity levelsPain prevalenceAnalgesic medicationPain sitesPain statusHealth visitsMedication usePain intensityPain treatmentRoutine appointments
2005
Identifying the Activities Affected by Chronic Nonmalignant Pain in Older Veterans Receiving Primary Care
Duong BD, Kerns RD, Towle V, Reid MC. Identifying the Activities Affected by Chronic Nonmalignant Pain in Older Veterans Receiving Primary Care. Journal Of The American Geriatrics Society 2005, 53: 687-694. PMID: 15817018, DOI: 10.1111/j.1532-5415.2005.53220.x.Peer-Reviewed Original ResearchConceptsChronic nonmalignant painNonmalignant painChronic painDaily livingAverage pain intensity scoreOlder personsOlder primary care patientsVeterans Affairs Medical CenterPain intensity scoresPain-related disabilityPrimary care patientsPrimary care practicesProportion of participantsCross-sectional surveyCare patientsPrimary careInstrumental activitiesMedical CenterOlder veteransPhysical activityPainCare practicesIntensity scoresOlder individualsRecreational activities
2004
Identification of Strategies Used to Cope with Chronic Pain in Older Persons Receiving Primary Care from a Veterans Affairs Medical Center
Barry LC, Kerns RD, Guo Z, Duong BD, Iannone LP, Reid MC. Identification of Strategies Used to Cope with Chronic Pain in Older Persons Receiving Primary Care from a Veterans Affairs Medical Center. Journal Of The American Geriatrics Society 2004, 52: 950-956. PMID: 15161460, DOI: 10.1111/j.1532-5415.2004.52263.x.Peer-Reviewed Original ResearchConceptsVeterans Affairs Medical CenterChronic painOlder personsAnalgesic medicationMedical CenterOlder primary care patientsChronic noncancer painCognitive coping methodsTrauma-related painCross-sectional telephone surveyPrimary care patientsPrimary care practicesProportion of participantsNoncancer painPain characteristicsCare patientsMusculoskeletal causesPrimary carePainActivity restrictionCare practicesMultivariate analysisAscertain factorsOlder populationCoping strategies
2003
Functional self-efficacy and pain-related disability among older veterans with chronic pain in a primary care setting
Barry LC, Guo Z, Kerns RD, Duong BD, Reid M. Functional self-efficacy and pain-related disability among older veterans with chronic pain in a primary care setting. Pain 2003, 104: 131-137. PMID: 12855322, DOI: 10.1016/s0304-3959(02)00471-2.Peer-Reviewed Original ResearchConceptsPain-related disabilityChronic painOlder veteransVA Connecticut Healthcare SystemPrimary care settingMean agePotential confoundersPrimary careCare settingsIndependent factorsPainWest HavenRestricted activityPast monthSelf-Efficacy QuestionnaireMore daysHealthcare systemMost participantsDisabilitySelf-efficacy groupVeteransParticipantsConfoundersYearsPrevalenceVeterans reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system
Kerns RD, Otis J, Rosenberg R, Reid MC. Veterans reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system. The Journal Of Rehabilitation Research And Development 2003, 40: 371. PMID: 15080222, DOI: 10.1682/jrrd.2003.09.0371.Peer-Reviewed Original ResearchConceptsPresence of painMental health servicesHealth risk behaviorsHealth servicesVHA primary care settingsVeterans Health Administration facilitiesUse of outpatientPain management strategiesPrimary care settingPrimary care providersRatings of healthEmotional distressSelf-rated healthIndex visitHealth-related concernsPain complaintsVHA facilitiesHigh prevalenceCare settingsCare providersPainMore outpatientGreater emotional distressAdministration facilitiesAlcohol use
2002
Pain-Related Disability Among Older Male Veterans Receiving Primary Care
Reid MC, Guo Z, Towle VR, Kerns RD, Concato J. Pain-Related Disability Among Older Male Veterans Receiving Primary Care. The Journals Of Gerontology Series A 2002, 57: m727-m732. PMID: 12403801, DOI: 10.1093/gerona/57.11.m727.Peer-Reviewed Original ResearchConceptsPain-related disabilityHigh pain-related disabilityPresence of painOlder male veteransPain intensityPrimary careDepressive symptomsMale veteransModerate pain-related disabilityOlder personsVeterans Affairs primary care clinicsEpidemiologic Studies Depression ScaleNumeric rating scalePrimary care clinicsLow back painCross-sectional studyMost daysPain characteristicsOne-unit increaseBack painCare clinicsSubstantial disabilityModifiable factorsOlder veteransPainUse of Opioid Medications for Chronic Noncancer Pain Syndromes in Primary Care
Reid MC, Engles‐Horton L, Weber MB, Kerns RD, Rogers EL, O'Connor PG. Use of Opioid Medications for Chronic Noncancer Pain Syndromes in Primary Care. Journal Of General Internal Medicine 2002, 17: 173-179. PMID: 11929502, PMCID: PMC1495018, DOI: 10.1046/j.1525-1497.2002.10435.x.Peer-Reviewed Original ResearchConceptsChronic noncancer painChronic pain disordersPrimary care centersPrimary care settingNoncancer painOpioid medicationsAbuse/dependenceSubstance use disordersPain disordersPsychiatric comorbidityPCC patientsPrimary careCare settingsUse disordersLifetime historyVA primary care clinicsAlcohol abuse/dependenceRetrospective cohort studyProportion of patientsMedical record reviewPrimary care clinicsChronic pain diagnosesAbuse behaviorsDegenerative joint diseaseLifetime prevalence rates