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
Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016
Dahlhamer J, Lucas J, Zelaya C, Nahin R, Mackey S, DeBar L, Kerns R, Von Korff M, Porter L, Helmick C. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morbidity And Mortality Weekly Report 2018, 67: 1001-1006. PMID: 30212442, PMCID: PMC6146950, DOI: 10.15585/mmwr.mm6736a2.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChronic PainFemaleHealth SurveysHumansMaleMiddle AgedPrevalenceUnited StatesYoung AdultConceptsHigh-impact chronic painChronic painU.S. adultsNational Health Interview Survey dataHealth Interview Survey dataCommon reasons adultsNational Pain StrategyPain management interventionsSelf-care activitiesPopulation-based estimatesQuality of lifeInterview Survey dataPrecise prevalence estimatesPain strategiesPain servicePublic health insurancePain interventionsNormal life activitiesHigh prevalencePainPrevalence estimatesMedical careReasons adultsNational estimatesPrevalenceEvaluation of Complementary and Integrative Health Approaches Among US Veterans with Musculoskeletal Pain Using Propensity Score Methods
Han L, Goulet JL, Skanderson M, Bathulapalli H, Luther SL, Kerns RD, Brandt CA. Evaluation of Complementary and Integrative Health Approaches Among US Veterans with Musculoskeletal Pain Using Propensity Score Methods. Pain Medicine 2018, 20: 90-102. PMID: 29584926, PMCID: PMC6329442, DOI: 10.1093/pm/pny027.Peer-Reviewed Original ResearchConceptsIntegrative health approachesPS matchingCIH exposureMusculoskeletal painPropensity score methodsSelf-rated pain intensityHealth approachHigher pain intensity ratingsPain intensity outcomesChronic musculoskeletal painPain intensity ratingsIPTW modelsRetrospective cohortPain intensityChronic painClinical visitsInitial diagnosisChiropractic careUS veteransBaseline differencesTreatment weightingExposure groupPainScore methodTreatment effectiveness
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 sampleOpioidsOdds
2016
The musculoskeletal diagnosis cohort
Goulet JL, Kerns RD, Bair M, Becker W, Brennan P, Burgess DJ, Carroll CM, Dobscha S, Driscoll M, Fenton BT, Fraenkel L, Haskell S, Heapy A, Higgins D, Hoff RA, Hwang U, Justice AC, Piette JD, Sinnott P, Wandner L, Womack J, Brandt CA. The musculoskeletal diagnosis cohort. Pain 2016, 157: 1696-1703. PMID: 27023420, PMCID: PMC4949131, DOI: 10.1097/j.pain.0000000000000567.Peer-Reviewed Original ResearchConceptsMSD diagnosisMusculoskeletal disordersMSD cohortIndex dateVeterans Health Administration (VHA) careNumeric rating scale scoreICD-9-CM codesCohort inclusion criteriaNontraumatic joint disordersPain-related treatmentsMore outpatient visitsVeterans Health AdministrationMental health diagnosesRating Scale scoresHigher NRS scoresHealth services researchElectronic health recordsDiagnosis cohortSevere painInpatient visitsNRS scoresOutpatient visitsNeck disordersFirst diagnosisMean ageAssociation of Pain With Physical Function, Depressive Symptoms, Fatigue, and Sleep Quality Among Veteran and non-Veteran Postmenopausal Women
Patel KV, Cochrane BB, Turk DC, Bastian LA, Haskell SG, Woods NF, Zaslavsky O, Wallace RB, Kerns RD. Association of Pain With Physical Function, Depressive Symptoms, Fatigue, and Sleep Quality Among Veteran and non-Veteran Postmenopausal Women. The Gerontologist 2016, 56: s91-s101. PMID: 26768395, PMCID: PMC5881612, DOI: 10.1093/geront/gnv670.Peer-Reviewed Original ResearchConceptsExtreme pain interferencePain interferencePhysical functionPain severitySleep qualityDepressive symptomsHealth initiativesStudy participantsWorse physical functionAssociation of painWomen's Health InitiativeNon-veteran womenObservational study participantsLimited physical functioningVeteran statusHealth care servicesPostmenopausal womenLess painPhysical functioningOlder veteransHigh incidencePainCare servicesNumber of womenComorbid symptoms
2014
A 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 careToward Development of a Tinnitus Magnitude Index
Schmidt CJ, Kerns RD, Griest S, Theodoroff SM, Pietrzak RH, Henry JA. Toward Development of a Tinnitus Magnitude Index. Ear & Hearing 2014, 35: 476-484. PMID: 24603542, DOI: 10.1097/aud.0000000000000017.Peer-Reviewed Original ResearchConceptsTinnitus magnitudeEmotional reactionsPsychological distressThree-item scaleCognitive-behavioral mediation modelDiscriminant validityTinnitus Functional IndexTinnitus reactionsInternal consistencyGeneral depressive symptomsMediation modelTest-retest reliabilityDistress measuresBeck Depression InventoryTinnitus variablesGroup differencesValid measureModerate correlationTinnitus perceptionPreliminary evidenceDepression InventoryDepressive symptomsTestable modelDistressAudiology clinicEffect of variability in the 7-day baseline pain diary on the assay sensitivity of neuropathic pain randomized clinical trials: An ACTTION study
Farrar JT, Troxel AB, Haynes K, Gilron I, Kerns RD, Katz NP, Rappaport BA, Rowbotham MC, Tierney AM, Turk DC, Dworkin RH. Effect of variability in the 7-day baseline pain diary on the assay sensitivity of neuropathic pain randomized clinical trials: An ACTTION study. Pain 2014, 155: 1622-1631. PMID: 24831421, DOI: 10.1016/j.pain.2014.05.009.Peer-Reviewed Original ResearchConceptsDiabetic peripheral neuropathyLikelihood of responseClinical trialsPostherpetic neuralgiaPainful diabetic peripheral neuropathyAddiction Clinical Trial TranslationsNetworks (ACTTION) public-private partnershipBaseline pain levelsPlacebo-treated groupRandomized clinical trialsAnalgesic clinical trialsPatient-level dataClinical trial dataExploratory logistic regressionAvailable baseline factorsNeuropathic painPain diaryPain levelsBaseline factorsPain therapyPeripheral neuropathyPatient sexPatients' baselinePain ratingsStudy protocol
2012
The Practitioner Proposes a Treatment Change and the Patient Declines: What to do next?
Falzer PR, Leventhal HL, Peters E, Fried TR, Kerns R, Michalski M, Fraenkel L. The Practitioner Proposes a Treatment Change and the Patient Declines: What to do next? Pain Practice 2012, 13: 215-226. PMID: 23462141, PMCID: PMC3668345, DOI: 10.1111/j.1533-2500.2012.00573.x.Peer-Reviewed Original Research
2011
Measuring Pain Impact Versus Pain Severity Using a Numeric Rating Scale
Fraenkel L, Falzer P, Fried T, Kohler M, Peters E, Kerns R, Leventhal H. Measuring Pain Impact Versus Pain Severity Using a Numeric Rating Scale. Journal Of General Internal Medicine 2011, 27: 555-560. PMID: 22081365, PMCID: PMC3326111, DOI: 10.1007/s11606-011-1926-z.Peer-Reviewed Original ResearchConceptsNumeric rating scaleImpact of painPain impactPatient preferencesPain intensity numeric rating scaleRating ScalePatients' treatment preferencesResultsTwo hundred fortyMore effective treatmentsHigh-risk treatmentValuable screening instrumentPain severityCurrent medicationsMusculoskeletal painNRS scoresClinical outcomesIllness perceptionsPhysical functionTreatment preferencesHundred fortyEffective treatmentPainClinical practiceAppropriate managementScreening instrument
2006
Higher levels of pain readiness to change and more positive affect reduce pain reports – A weekly assessment study on arthritis patients
Strand EB, Kerns RD, Christie A, Haavik-Nilsen K, Klokkerud M, Finset A. Higher levels of pain readiness to change and more positive affect reduce pain reports – A weekly assessment study on arthritis patients. Pain 2006, 127: 204-213. PMID: 16997472, DOI: 10.1016/j.pain.2006.08.015.Peer-Reviewed Original Research
2005
Identification of Pain-Reduction Strategies Used by Community-Dwelling Older Persons
Barry LC, Gill TM, Kerns RD, Reid MC. Identification of Pain-Reduction Strategies Used by Community-Dwelling Older Persons. The Journals Of Gerontology Series A 2005, 60: 1569-1575. PMID: 16424290, DOI: 10.1093/gerona/60.12.1569.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overChronic DiseaseCross-Sectional StudiesFemaleHumansMalePainSelf MedicationConceptsPain reduction strategiesLogistic regression analysisOlder personsChronic painCommunity-Dwelling Older PersonsAnalgesic medication useParticipant-related factorsChronic nonmalignant painManagement of painCommunity-dwelling personsCross-sectional studyMost participantsRegression analysisNonmalignant painPain statusMedication useSubstantial painMean agePainActivity restrictionEfficacious strategyCold modalitiesMean numberParticipantsPersonsPerceived Barriers to Trying Self‐Management Approaches for Chronic Pain in Older Persons
Austrian JS, Kerns RD, Reid MC. Perceived Barriers to Trying Self‐Management Approaches for Chronic Pain in Older Persons. Journal Of The American Geriatrics Society 2005, 53: 856-861. PMID: 15877564, DOI: 10.1111/j.1532-5415.2005.53268.x.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overChronic DiseaseCross-Sectional StudiesExercise TherapyFemaleHumansMalePain ManagementRelaxation TherapySelf CareConceptsChronic painRelaxation therapyGeneral Clinical Research CenterOlder personsOlder primary care patientsPain management strategiesPatient-level barriersPrimary care patientsClinical Research CenterFear of painAmbulatory care practicesCross-sectional surveySelf-management approachWeill Cornell Medical CollegeCurrent usePain statusCare patientsCornell Medical CollegeExercise programPainCare practicesEfficacy concernsMedical CollegeRestricted activityRelaxation program
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
Cognitive–Behavioral Therapy for Chronic Low Back Pain in Older Persons: A Preliminary Study
Reid MC, Otis J, Barry LC, Kerns RD. Cognitive–Behavioral Therapy for Chronic Low Back Pain in Older Persons: A Preliminary Study. Pain Medicine 2003, 4: 223-230. PMID: 12974821, DOI: 10.1046/j.1526-4637.2003.03030.x.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBehavior TherapyChronic DiseaseCognitive Behavioral TherapyConnecticutFemaleHumansLow Back PainMalePilot ProjectsConceptsChronic low back painCognitive behavioral therapyLow back painPain intensityOlder personsBack painParticipants' pain intensityPain-related disabilityPain-related disability scoresUncontrolled pilot studyWeekly individual sessionsSocial activity levelsDisability scoresMean agePretreatment levelsFeasible treatmentTreatment sessionsPosttreatment assessmentPotential efficacyBehavioral therapyPilot studyWeeksMean numberActivity levelsPainFunctional 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
Use 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
1997
Readiness to adopt a self-management approach to chronic pain: the Pain Stages of Change Questionnaire (PSOCQ)
Kerns R, Rosenberg R, Jamison R, Caudill M, Haythornthwaite J. Readiness to adopt a self-management approach to chronic pain: the Pain Stages of Change Questionnaire (PSOCQ). Pain 1997, 72: 227-234. PMID: 9272807, DOI: 10.1016/s0304-3959(97)00038-9.Peer-Reviewed Original Research