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 disorderAn Analysis of the Role of Mental Health in a Randomized Trial of a Walking Intervention for Black Veterans With Chronic Pain
Hammett PJ, Eliacin J, Makris UE, Allen KD, Kerns RD, Heapy A, Goldsmith ES, Meis LA, Taylor BC, Saenger M, Cross LJS, Do T, Branson M, Burgess DJ. An Analysis of the Role of Mental Health in a Randomized Trial of a Walking Intervention for Black Veterans With Chronic Pain. Journal Of Pain 2022, 24: 55-67. PMID: 36162790, DOI: 10.1016/j.jpain.2022.07.002.Peer-Reviewed Original ResearchConceptsMental health disordersPain-related disabilityCo-occurring mental health disordersUsual careChronic painHealth disordersIntensive treatmentBlack veteransVA health care systemChronic musculoskeletal painChronic pain patientsMental health diagnosesTelephone coaching sessionsHealth care systemMusculoskeletal painPain patientsBlack patientsPainSecondary analysisPatientsMental healthCare systemHealth diagnosisIntervention effectivenessDisordersAssociation 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 facilitiesEngaging Veterans and Military Service Members to Optimize Pragmatic Clinical Trials of Nonpharmacological Approaches for Pain Management
Anicich A, Katsovich L, Kerns RD. Engaging Veterans and Military Service Members to Optimize Pragmatic Clinical Trials of Nonpharmacological Approaches for Pain Management. Pain Medicine 2022, 23: pnac020-. PMID: 35143672, PMCID: PMC9425849, DOI: 10.1093/pm/pnac020.Peer-Reviewed Original ResearchRisk 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
Optimizing the Impact of Pragmatic Clinical Trials for Veteran and Military Populations: Lessons From the Pain Management Collaboratory
Ali J, Antonelli M, Bastian L, Becker W, Brandt CA, Burgess DJ, Burns A, Cohen SP, Davis AF, Dearth CL, Dziura J, Edwards R, Erdos J, Farrokhi S, Fritz J, Geda M, George SZ, Goertz C, Goodie J, Hastings SN, Heapy A, Ilfeld BM, Katsovich L, Kerns RD, Kyriakides TC, Lee A, Long CR, Luther SL, Martino S, Matheny ME, McGeary D, Midboe A, Pasquina P, Peduzzi P, Raffanello M, Rhon D, Rosen M, Esposito ER, Scarton D, Hastings SN, Seal K, Silliker N, Taylor S, Taylor SL, Tsui M, Wright FS, Zeliadt S. Optimizing the Impact of Pragmatic Clinical Trials for Veteran and Military Populations: Lessons From the Pain Management Collaboratory. Military Medicine 2021, 187: 179-185. PMID: 34791412, PMCID: PMC9389906, DOI: 10.1093/milmed/usab458.Peer-Reviewed Original ResearchConceptsPragmatic clinical trialsPain Management CollaboratoryClinical trialsMultisite pragmatic clinical trialManagement of painDual public health crisesCommon co-occurring conditionsPragmatic trial designUnmet healthcare needsMilitary Health SystemCo-occurring conditionsPublic health crisisPain managementChronic painNonpharmacological approachesOpioid misuseMultifactorial etiologyTrial designVeterans AffairsMilitary populationHealthcare needsHealth systemNational InstitutePainCOVID-19 pandemicMeasuring 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 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 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 survivorsWomenDiagnosisTraumaVeteransLong-term Patterns of Self-reported Opioid Use, VACS Index, and Mortality Among People with HIV Engaged in Care
Adams JW, Li Y, Barry DT, Gordon KS, Kerns RD, Oldfield BJ, Rentsch CT, Marshall BDL, Edelman EJ. Long-term Patterns of Self-reported Opioid Use, VACS Index, and Mortality Among People with HIV Engaged in Care. AIDS And Behavior 2021, 25: 2951-2962. PMID: 33569682, PMCID: PMC8442670, DOI: 10.1007/s10461-021-03162-7.Peer-Reviewed Original ResearchDevelopment and Implementation of the Military Treatment Facility Engagement Committee (MTFEC) to Support Pragmatic Clinical Trials in the Military Health System
Scarton DV, Roddy WT, Taylor JA, Geda M, Brandt CA, Peduzzi P, Kerns RD, Pasquina PF. Development and Implementation of the Military Treatment Facility Engagement Committee (MTFEC) to Support Pragmatic Clinical Trials in the Military Health System. Military Medicine 2021, 186: 70-75. PMID: 33499543, PMCID: PMC7980475, DOI: 10.1093/milmed/usaa368.Peer-Reviewed Original ResearchConceptsPain Management CollaboratoryPragmatic clinical trialsMilitary treatment facilitiesHealth care systemPain managementClinical trialsDOD health care systemVA health care systemCare systemChronic pain managementService membersTraumatic brain injuryMilitary Health SystemMilitary service membersChronic painNonpharmacological approachesBrain injuryLimb lossClinical practiceHealth systemCoordinating CenterTrialsVA programsNational InstituteDepartment of Defense
2020
Stakeholder Engagement in Pragmatic Clinical Trials: Emphasizing Relationships to Improve Pain Management Delivery and Outcomes
Bastian LA, Cohen SP, Katsovich L, Becker WC, Brummett BR, Burgess DJ, Crunkhorn AE, Denneson LM, Frank JW, Goertz C, Ilfeld B, Kanzler KE, Krishnaswamy A, LaChappelle K, Martino S, Mattocks K, McGeary CA, Reznik TE, Rhon DI, Salsbury SA, Seal KH, Semiatin AM, Shin MH, Simon CB, Teyhen DS, Zamora K, Kerns RD, Collaboratory T. Stakeholder Engagement in Pragmatic Clinical Trials: Emphasizing Relationships to Improve Pain Management Delivery and Outcomes. Pain Medicine 2020, 21: s13-s20. PMID: 33313726, PMCID: PMC7824996, DOI: 10.1093/pm/pnaa333.Peer-Reviewed Original ResearchConceptsPragmatic clinical trialsPain Management CollaboratoryTarget treatment populationClinical trialsManagement of painPrimary care cliniciansHealth care teamCo-occurring conditionsMilitary service membersCare cliniciansNonpharmacological approachesPragmatic trialCare teamPain researchHealth system leadersTreatment populationTrial researchersCoordinating CenterHealth OrganizationTrialsService membersPainPrincipal investigatorManagement deliveryGroupNIH-DOD-VA Pain Management Collaboratory: Pragmatic Clinical Trials of Nonpharmacological Approaches for Management of Pain and Co-occurring Conditions in Veteran and Military Health Systems: Introduction
Kerns RD, Brandt CA. NIH-DOD-VA Pain Management Collaboratory: Pragmatic Clinical Trials of Nonpharmacological Approaches for Management of Pain and Co-occurring Conditions in Veteran and Military Health Systems: Introduction. Pain Medicine 2020, 21: s1-s4. PMID: 33313722, DOI: 10.1093/pm/pnaa358.Peer-Reviewed Original ResearchPredictors 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 mortalityPLWHMortalityHIVPatientsDoseNeuropsychological 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 disordersAre 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
High-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 veterans