2024
Pain, Substance Use Disorders, Mental Health, and Buprenorphine Treatment among Patients With and Without HIV
Miller E, McGinnis K, Edelman E, Feinberg T, Gordon K, Kerns R, Marshall B, Patterson J, McRae M. Pain, Substance Use Disorders, Mental Health, and Buprenorphine Treatment among Patients With and Without HIV. AIDS And Behavior 2024, 28: 3994-4004. PMID: 39264485, PMCID: PMC11586311, DOI: 10.1007/s10461-024-04494-w.Peer-Reviewed Original ResearchMental health classesSubstance use disordersOpioid use disorderHIV statusBuprenorphine initiationVeterans Aging Cohort StudyInitiate buprenorphineMental health diagnosesAging Cohort StudyBuprenorphine treatmentMultiple pain conditionsAssociated with HIV statusInfluence treatment retentionUse disorderTreatment of opioid use disorderHigher comorbidity burdenAge of patientsClinical encountersMental healthHealth diagnosisBlack veteransHealth classesLatent class analysisCohort studyPrescription data
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
2020
Treatment of a Large Cohort of Veterans Experiencing Musculoskeletal Disorders with Spinal Cord Stimulation in the Veterans Health Administration: Veteran Characteristics and Outcomes
Wandner LD, Fenton BT, Goulet JL, Carroll CM, Heapy A, Higgins DM, Bair MJ, Sandbrink F, Kerns RD. Treatment of a Large Cohort of Veterans Experiencing Musculoskeletal Disorders with Spinal Cord Stimulation in the Veterans Health Administration: Veteran Characteristics and Outcomes. Journal Of Pain Research 2020, 13: 1687-1697. PMID: 32753944, PMCID: PMC7354010, DOI: 10.2147/jpr.s241567.Peer-Reviewed Original ResearchMusculoskeletal disordersSCS implantsOpioid therapyPain scoresVeterans Health Administration facilitiesSpinal cord stimulator implantationOutcomes of veteransPainful musculoskeletal disordersSpinal cord stimulationVeterans Health AdministrationDepressive disorder diagnosisEvidence of benefitSubstance use disordersPercent of veteransSignificant overall decreaseMSD cohortOpioid doseBMI 25Medical comorbiditiesStimulator implantationChronic painCord stimulationInclusion diagnosisVeteran characteristicsLarge cohort
2018
Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care
Barry DT, Marshall BDL, Becker WC, Gordon AJ, Crystal S, Kerns RD, Gaither JR, Gordon KS, Justice AC, Fiellin DA, Edelman EJ. Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care. Drug And Alcohol Dependence 2018, 191: 348-354. PMID: 30176548, PMCID: PMC6596307, DOI: 10.1016/j.drugalcdep.2018.07.008.Peer-Reviewed Original ResearchConceptsPrescription opioid receiptPrescription opioidsMedical careOpioid receiptVeterans Health Administration primary careNonmedical useMultivariable Cox modelInfectious disease clinicProspective cohort studyProportional hazards regressionPrescription opioid medicationsPublic health problemSubstance use disordersMedication-related characteristicsOpioid therapyOpioid medicationsOpioid prescriptionsCohort studyDisease clinicMedian ageHazards regressionEligible participantsPrimary careRisk factorsIncidence rate
2017
Gender Differences in Demographic and Clinical Correlates among Veterans with Musculoskeletal Disorders
Higgins DM, Fenton BT, Driscoll MA, Heapy AA, Kerns RD, Bair MJ, Carroll C, Brennan PL, Burgess DJ, Piette JD, Haskell SG, Brandt CA, Goulet JL. Gender Differences in Demographic and Clinical Correlates among Veterans with Musculoskeletal Disorders. Women's Health Issues 2017, 27: 463-470. PMID: 28325585, DOI: 10.1016/j.whi.2017.01.008.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnxietyChronic PainCohort StudiesFemaleHumansMaleMiddle AgedMigraine DisordersMusculoskeletal DiseasesMusculoskeletal PainPain ManagementSeverity of Illness IndexSex FactorsSocioeconomic FactorsSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsMusculoskeletal disordersClinical correlatesPain intensity numeric rating scalePain-related disabilityNumeric rating scaleGreater pain intensityDiagnosis of fibromyalgiaBack pain conditionsMental health conditionsSubstance use disordersGender differencesNeck painPain serviceSevere painPain conditionsPain intensityChronic painTemporomandibular disordersPainful conditionsCardiovascular diseaseMigraine headacheHigh riskLower oddsMSD diagnosisUse disorders
2016
The Effect of Substance Use Disorders on the Association Between Guideline-concordant Long-term Opioid Therapy and All-cause Mortality
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Justice AC, Fiellin DA. The Effect of Substance Use Disorders on the Association Between Guideline-concordant Long-term Opioid Therapy and All-cause Mortality. Journal Of Addiction Medicine 2016, 10: 418-428. PMID: 27610580, PMCID: PMC5083184, DOI: 10.1097/adm.0000000000000255.Peer-Reviewed Original ResearchConceptsSubstance use disordersLong-term opioid therapyCause mortalityOpioid therapySUD treatmentUse disordersLower mortalityTime-updated Cox regressionUntreated substance use disordersVeterans Aging Cohort StudyOpioid-prescribing guidelinesGuideline-concordant careSUD statusAging Cohort StudyClinical practice guidelinesSUD treatment servicesOverall sampleHIV patientsCohort studyCox regressionPractice guidelinesPatientsTreatment servicesHigh mortalityMortalityPsychiatric Disorders Among Patients Seeking Treatment for Co-Occurring Chronic Pain and Opioid Use Disorder.
Barry DT, Cutter CJ, Beitel M, Kerns RD, Liong C, Schottenfeld RS. Psychiatric Disorders Among Patients Seeking Treatment for Co-Occurring Chronic Pain and Opioid Use Disorder. The Journal Of Clinical Psychiatry 2016, 77: 1413-1419. PMID: 27574837, PMCID: PMC6296217, DOI: 10.4088/jcp.15m09963.Peer-Reviewed Original ResearchConceptsOpioid use disorderCo-occurring chronic painChronic painAxis I DisordersUse disordersPsychiatric disordersI disordersMood disordersCo-occurring opioid use disorderBuprenorphine/naloxone treatmentNonopioid substance use disordersDSM-IV-TR Axis I DisordersCo-occurring psychiatric disordersAnxiety disordersMajority of patientsPersonality disorderMethadone maintenance treatmentTreatment of patientsComorbid psychiatric disordersLifetime mood disordersMajor depressive disorderStructured Clinical InterviewLifetime anxiety disorderSubstance use disordersTreatment Research ProgramThe Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality
Gaither JR, Goulet JL, Becker WC, Crystal S, Edelman EJ, Gordon K, Kerns RD, Rimland D, Skanderson M, Justice AC, Fiellin DA. The Association Between Receipt of Guideline-Concordant Long-Term Opioid Therapy and All-Cause Mortality. Journal Of General Internal Medicine 2016, 31: 492-501. PMID: 26847447, PMCID: PMC4835362, DOI: 10.1007/s11606-015-3571-4.Peer-Reviewed Original ResearchConceptsSubstance use disordersGuideline-concordant careCause mortalityOpioid therapyLong-term opioid therapyUntreated substance use disordersCurrent substance use disorderTerm opioid therapyTime-updated covariatesPrimary care visitsImportant clinical outcomesMulti-modal treatmentUrine drug testingUninfected patientsUntreated patientsCare visitsChronic painClinical outcomesCox regressionDecreased riskHigh comorbidityMortality burdenRehabilitative therapySUD treatmentHigh risk
2015
Evaluation of a Telementoring Intervention for Pain Management in the Veterans Health Administration
Frank JW, Carey EP, Fagan KM, Aron DC, Todd-Stenberg J, Moore BA, Kerns RD, Au DH, Ho PM, Kirsh SR. Evaluation of a Telementoring Intervention for Pain Management in the Veterans Health Administration. Pain Medicine 2015, 16: 1090-1100. PMID: 25716075, DOI: 10.1111/pme.12715.Peer-Reviewed Original ResearchConceptsPrimary care providersChronic noncancer painVeterans Health AdministrationCare providersPatient panelMultivariable Cox proportional hazards modelsHealth AdministrationCox proportional hazards modelPain management competencyPhysical medicine servicesSpecialty pain clinicPain management educationPain management programProportional hazards modelSubstance use disordersNoncancer painNonopioid medicationsMedication initiationAnticonvulsant medicationPain clinicOpioid analgesicsPain managementChronic painPain careSpecialist consultation
2014
Guideline-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 characteristicsPatientsPersistent Pain and Comorbidity Among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans
Higgins DM, Kerns RD, Brandt CA, Haskell SG, Bathulapalli H, Gilliam W, Goulet JL. Persistent Pain and Comorbidity Among Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans. Pain Medicine 2014, 15: 782-790. PMID: 24548466, DOI: 10.1111/pme.12388.Peer-Reviewed Original ResearchMeSH KeywordsAdultAfghan Campaign 2001-Chronic PainComorbidityDepressive DisorderFemaleHumansIraq War, 2003-2011Logistic ModelsLongitudinal StudiesMaleMiddle AgedMultivariate AnalysisObesityPrevalenceStress Disorders, Post-TraumaticSubstance-Related DisordersUnited StatesUnited States Department of Veterans AffairsVeteransConceptsVeterans Health AdministrationTraumatic brain injuryPersistent painBody mass indexMental health conditionsChronic painOperation Enduring FreedomHealth conditionsElectronic medical record dataChronic pain conditionsPredictors of incidentMedical record dataLongitudinal clinical dataImportant clinical implicationsSubstance use disordersOEF/OIF/OND veteransPost-traumatic stress disorderArmy service membersLogistic regression modelsPain conditionsComorbid conditionsClinical evidenceMass indexBrain injuryClinical data
2007
Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction.
Martell BA, O'Connor PG, Kerns RD, Becker WC, Morales KH, Kosten TR, Fiellin DA. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Annals Of Internal Medicine 2007, 146: 116-27. PMID: 17227935, DOI: 10.7326/0003-4819-146-2-200701160-00006.Peer-Reviewed Original ResearchConceptsChronic back painSubstance use disordersEfficacy of opioidsBack painMedication-taking behaviorUse disordersOpioid treatmentOpioid medicationsStudy qualityShort-term pain reliefCurrent substance use disorderCochrane Central RegisterLifetime substance use disorderControlled Clinical TrialsLong-term efficacyPoor study qualityEnglish-language studiesTransdermal opioidsOpioid prescribingPain reliefCentral RegisterDifferent opioidsReduced painClinical trialsNonsignificant reduction
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