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
2023
Metformin prescription for U.S. veterans with prediabetes, 2010–2019
Gulanski B, Goulet J, Radhakrishnan K, Ko J, Li Y, Rajeevan N, Lee K, Heberer K, Lynch J, Streja E, Mutalik P, Cheung K, Concato J, Shih M, Lee J, Aslan M. Metformin prescription for U.S. veterans with prediabetes, 2010–2019. Journal Of Investigative Medicine 2023, 72: 139-150. PMID: 37668313, DOI: 10.1177/10815589231201141.Peer-Reviewed Original ResearchConceptsBody mass indexVeterans Health AdministrationIncident prediabetesHigh riskHealth AdministrationRetrospective observational cohort studyType 2 diabetes mellitusUse of metforminObservational cohort studyProportion of veteransMetformin prescribingGestational diabetesCohort studyMetformin prescriptionDiabetes mellitusDiabetes preventionMass indexCardiovascular diseaseMultivariable modelPrediabetesSubset of individualsMetforminU.S. veteransHealthcare systemVeteransFall-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 ResearchConceptsFall-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 ResearchConceptsGraded 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 ResearchConceptsOpioid 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 ResearchConceptsCommunity 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 ResearchConceptsBack 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 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 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 ResearchConceptsCommunity 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 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 visitsPain intensity and pain medication prescription patterns in Veterans with heart failure and back pain
Cavanagh CE, Rosman L, Chui PW, DeRycke E, Bathulapalli H, Gandhi P, Bastian LA, Burg MM, Brandt C, Goulet JL. Pain intensity and pain medication prescription patterns in Veterans with heart failure and back pain. Heart & Lung 2021, 50: 770-774. PMID: 34225088, DOI: 10.1016/j.hrtlng.2021.04.016.Peer-Reviewed Original ResearchConceptsComorbid heart failureHeart failureBack painPain intensityMedication prescription patternsPain medication prescriptionsHigher likelihoodGabapentin prescriptionsNSAID prescriptionsPrescription patternsSevere painPain conditionsMedication prescriptionsClinical managementPainMusculoskeletal disordersDisorder cohortLower likelihoodVeteransFurther studiesPrescriptionFailureOpioidsCardiovascularCohortMilitary 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 survivorsWomenDiagnosisTraumaVeteransICD-10 Coding of Musculoskeletal Conditions in the Veterans Health Administration
Coleman BC, Goulet JL, Higgins DM, Bathulapalli H, Kawecki T, Ruser CB, Bastian LA, Martino S, Piette JD, Edmond SN, Heapy AA. ICD-10 Coding of Musculoskeletal Conditions in the Veterans Health Administration. Pain Medicine 2021, 22: 2597-2603. PMID: 33944953, PMCID: PMC8783617, DOI: 10.1093/pm/pnab161.Peer-Reviewed Original ResearchConceptsSpecialty care settingsVeterans Health AdministrationCare settingsDiagnosis codesMusculoskeletal diagnosesMusculoskeletal conditionsHealth AdministrationVeterans Health Administration (VHA) careLow back painLongitudinal cohort studyICD-10 codingVisit diagnosesCohort studyDiagnosis cohortBack painCommon diagnosisUnique patientsNumber of visitsInternational ClassificationMusculoskeletal carePotential diagnosisSecondary analysisPatientsDiagnosisMusculoskeletal systemDocumentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study
Brandt CA, Workman TE, Farmer MM, Akgün KM, Abel EA, Skanderson M, Bean-Mayberry B, Zeng-Treitler Q, Mason M, Bastian LA, Goulet JL, Post LA. Documentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study. Western Journal Of Emergency Medicine 2021, 22: 525-532. PMID: 34125022, PMCID: PMC8203018, DOI: 10.5811/westjem.2021.4.51203.Peer-Reviewed Original ResearchConceptsClinical notesPatient characteristicsHealthcare providersFirearm accessElectronic health record clinical notesProportion of patientsOutpatient care visitsVeterans Healthcare SystemCohort of veteransUnited States military veteransMilitary service characteristicsDocumentation of screeningDocumentation of accessFirst yearRace/ethnicityCare visitsOutpatient visitsClinical comorbiditiesRetrospective studyVHA careEmergency clinicHandling of firearmsDemographic dataSystemwide processRisk of violenceExamining 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 ResearchConceptsVeterans 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
Are 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 dataSuicidal ideation, behavior, and mortality in male and female US veterans with severe mental illness
Aslan M, Radhakrishnan K, Rajeevan N, Sueiro M, Goulet JL, Li Y, Depp C, Concato J, Harvey PD. Suicidal ideation, behavior, and mortality in male and female US veterans with severe mental illness. Journal Of Affective Disorders 2020, 267: 144-152. PMID: 32063566, DOI: 10.1016/j.jad.2020.02.022.Peer-Reviewed Original ResearchMeSH KeywordsBipolar DisorderFemaleHumansMaleRisk FactorsSuicidal IdeationSuicide, AttemptedVeteransConceptsSuicidal ideationCause mortalityBipolar disorderFemale veteransSuicide attemptsMore lifetime suicide attemptsMedical-psychiatric comorbidityLower overall mortalitySevere mental illnessPutative risk factorsLifetime suicidal ideationSelf-reported suicidal ideationLifetime suicide attemptsSuicide-specific mortalityClinical characteristicsOverall mortalityCox regressionPsychiatric comorbidityRisk factorsUS veteransCrude rateHigh riskSame diagnosisGeneral populationMale veterans
2019
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV
Oldfield BJ, McGinnis KA, Edelman EJ, Williams EC, Gordon AJ, Akgün K, Crystal S, Fiellin LE, Gaither JR, Goulet JL, Korthuis PT, Marshall BDL, Justice AC, Bryant K, Fiellin DA, Kraemer KL. Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV. Journal Of Substance Use And Addiction Treatment 2019, 109: 14-22. PMID: 31856946, PMCID: PMC6982467, DOI: 10.1016/j.jsat.2019.11.002.Peer-Reviewed Original ResearchConceptsAlcohol use disorderUse disordersHIV statusUninfected individualsVeterans Aging Cohort Study (VACS) dataEvidence-based medicationsNew alcohol use disorderPrevalence of initiationMultivariable logistic regressionPredictors of initiationFacility-level predictorsCohort study dataMedication initiationPrescription fillsMultivariable analysisBlack raceTreatment gapDecreased oddsNew diagnosisPLWHOlder ageLogistic regressionMedicationsHIVSpecific subpopulationsScreening 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 ResearchConceptsMilitary 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