2024
Stepped Care for Patients to Optimize Whole Recovery (SC-POWR): An Effectiveness Trial Evaluating a Stepped Care Model for Individuals With Opioid Use Disorder and Chronic Pain.
Rossi R, Cutter C, Beitel M, Covelli M, Fiellin D, Kerns R, Vassilieva S, Olabisi D, Barry D. Stepped Care for Patients to Optimize Whole Recovery (SC-POWR): An Effectiveness Trial Evaluating a Stepped Care Model for Individuals With Opioid Use Disorder and Chronic Pain. Substance Use & Addiction Journal 2024, 29767342241245095. PMID: 38606900, PMCID: PMC11470109, DOI: 10.1177/29767342241245095.Peer-Reviewed Original ResearchTreatment-as-usualOpioid use disorderChronic painCognitive behavioral therapyStepped careNonmedical opioid useEffectiveness trialOpioid useAlcohol useSession of exerciseStepped care modelWeekly group sessionsPain-related outcomesStress reductionDecreased pain intensityUse disorderNational Institutes of HealthOpioid use disorder treatmentCare modelInstitutes of HealthAssociated with higher levelsPain intensityPilot study of patientsPain improvementDurability of treatment response
2022
Brief Educational Video plus Telecare to Enhance Recovery for Older Emergency Department Patients with Acute Musculoskeletal Pain: an update to the study protocol for a randomized controlled trial
Hurka-Richardson K, Platts-Mills TF, McLean SA, Weinberger M, Stearns SC, Bush M, Quackenbush E, Chari S, Aylward A, Kroenke K, Kerns RD, Weaver MA, Keefe FJ, Berkoff D, Meyer ML. Brief Educational Video plus Telecare to Enhance Recovery for Older Emergency Department Patients with Acute Musculoskeletal Pain: an update to the study protocol for a randomized controlled trial. Trials 2022, 23: 400. PMID: 35550175, PMCID: PMC9096747, DOI: 10.1186/s13063-022-06310-z.Peer-Reviewed Original ResearchConceptsUrgent care clinicMusculoskeletal painCare clinicsOlder emergency department (ED) patientsAcute care visitsAcute musculoskeletal painEmergency department patientsWeeks of enrollmentCOVID-19 pandemicBrief educational videoCare visitsOpioid useDepartment patientsChronic painEmergency departmentStudy protocolFavorable outcomeInclusion criteriaRecruitment sitesEligibility criteriaMedical treatmentBETTER trialRemote recruitmentPainParticipant enrollmentLongitudinal analysis of the prevalence and correlates of heavy episodic drinking and self‐reported opioid use among a national cohort of patients with HIV
Oldfield BJ, Li Y, Vickers‐Smith R, Barry DT, Crystal S, Gordon KS, Kerns RD, Williams EC, Marshall BDL, Edelman EJ. Longitudinal analysis of the prevalence and correlates of heavy episodic drinking and self‐reported opioid use among a national cohort of patients with HIV. Alcohol Clinical And Experimental Research 2022, 46: 600-613. PMID: 35257397, PMCID: PMC9018502, DOI: 10.1111/acer.14801.Peer-Reviewed Original ResearchConceptsSelf-reported opioid useOpioid useHeavy episodic drinkingNational cohortRisk factorsDepressive symptomsVeterans Aging Cohort StudyVeterans Health Administration sitesOpioid-related risksHIV disease progressionModifiable risk factorsPast-year cigarette smokingAging Cohort StudyGreater illness severityEpisodic drinkingOpioid-related overdoseHigh-risk drinkingCohort studyProspective cohortIllness severityCigarette smokingClinical correlatesDisease progressionLower oddsMultinomial logistic regression
2021
Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV
Oldfield BJ, Li Y, Vickers-Smith R, Becker WC, Barry DT, Crystal S, Gordon KS, Kerns RD, Rentsch CT, Marshall BDL, Edelman EJ. Sociodemographic and clinical correlates of gabapentin receipt with and without opioids among a national cohort of patients with HIV. AIDS Care 2021, 34: 1053-1063. PMID: 34114904, PMCID: PMC8664891, DOI: 10.1080/09540121.2021.1939851.Peer-Reviewed Original ResearchConceptsOpioid useHigh dosesSelf-reported opioid useVeterans Aging Cohort StudyHigh-dose opioidsMean daily doseAging Cohort StudyHigh-dose benzodiazepinesNational prospective cohortOpioid doseOpioid receiptCohort studyFoot painProspective cohortDaily doseIndependent predictorsChronic painPain interferenceClinical variablesClinical correlatesNational cohortMultinomial logistic regressionPWHLogistic regressionOpioidsCorrelates of Manual Therapy and Acupuncture Use Among Rural Patients Seeking Conventional Pain Management: A Cross-sectional Study
Feinberg TM, Coleman B, Innes KE, Kerns RD, Jackson B, Lisi A, Majoris N, Brandt C. Correlates of Manual Therapy and Acupuncture Use Among Rural Patients Seeking Conventional Pain Management: A Cross-sectional Study. Journal Of Manipulative And Physiological Therapeutics 2021, 44: 330-343. PMID: 33896602, DOI: 10.1016/j.jmpt.2021.01.002.Peer-Reviewed Original ResearchConceptsComplementary health approachesManual therapyCross-sectional studyPain managementAcupuncture useHealth approachAge-adjusted logistic regressionConventional pain managementCurrent chronic painHigh pain burdenPrior opioid usePain scale scoresMind-body therapiesHealth-related factorsPain-related distressPain burdenOpioid useRheumatology clinicChronic painClinical outcomesPain carePain distressRural patientsMajority of participantsPrescription medicationsLong-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 Research
2020
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
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 mortalityPLWHMortalityHIVPatientsDoseIdentifying Multisite Chronic Pain with Electronic Health Records Data
Von Korff M, DeBar LL, Deyo RA, Mayhew M, Kerns RD, Goulet JL, Brandt C. Identifying Multisite Chronic Pain with Electronic Health Records Data. Pain Medicine 2020, 21: 3387-3392. PMID: 32918481, PMCID: PMC7770230, DOI: 10.1093/pm/pnaa295.Peer-Reviewed Original ResearchConceptsMultisite chronic painElectronic health care dataChronic painChronic pain impactElectronic health recordsHealth care dataCare dataPain impactHealth recordsLong-term opioid useCommon chronic pain conditionsPain-related disabilityChronic pain conditionsKaiser Permanente NorthwestElectronic health record dataHealth record dataPositive predictive valueOpioid usePain severityPain conditionsDepressive symptomsPainPredictive valueEpidemiological researchRecord dataBrief educational video plus telecare to enhance recovery for older emergency department patients with acute musculoskeletal pain: study protocol for the BETTER randomized controlled trial
Platts-Mills TF, McLean SA, Weinberger M, Stearns SC, Bush M, Teresi BB, Hurka-Richardson K, Kroenke K, Kerns RD, Weaver MA, Keefe FJ. Brief educational video plus telecare to enhance recovery for older emergency department patients with acute musculoskeletal pain: study protocol for the BETTER randomized controlled trial. Trials 2020, 21: 615. PMID: 32631400, PMCID: PMC7336469, DOI: 10.1186/s13063-020-04552-3.Peer-Reviewed Original ResearchConceptsChronic musculoskeletal painMusculoskeletal painEmergency departmentUsual careOpioid useChronic painOlder adultsAnalgesic-related side effectsLong-term opioid useOlder emergency department (ED) patientsAcute musculoskeletal painEmergency department patientsCause of disabilityPublic health priorityBrief educational videoDiscussionThis trialPain severitySecondary outcomesSixty patientsDepartment patientsPrimary outcomeHealthcare utilizationStudy enrollmentPhysical functionStudy protocolTrajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study.
Edelman EJ, Li Y, Barry D, Brennan Braden J, Crystal S, Kerns RD, Gaither JR, Gordon KS, Manhapra A, Merlin JS, Moore BA, Oldfield BJ, Park LS, Rentsch CT, Skanderson M, Williams EC, Justice AC, Tate JP, Becker WC, Marshall BDL. Trajectories of Self-Reported Opioid Use Among Patients With HIV Engaged in Care: Results From a National Cohort Study. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2020, 84: 26-36. PMID: 32267658, PMCID: PMC7147724, DOI: 10.1097/qai.0000000000002310.Peer-Reviewed Original ResearchConceptsOpioid useOpioid use trajectoriesCohort studyPain interferenceSelf-reported opioid useVeterans Aging Cohort StudyVeterans Health Administration sitesInfrequent useOpioid use frequencyMarijuana useAging Cohort StudyNational cohort studyEvidence-based treatmentsGroup-based trajectory modelsProspective cohortBaseline factorsIllness severityMultivariable analysisBenzodiazepine medicationVA carePsychoactive medicationsPrescription painkillersPsychiatric symptomsHeroin useMultinomial logistic regressionAre 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 misclassificationOddsCauseOpioids
2019
Signature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers
Giannitrapani KF, Fereydooni S, Azarfar A, Silveira MJ, Glassman PA, Midboe AM, Bohnert ABS, Zenoni MA, Kerns RD, Pearlman RA, Asch SM, Becker W, Lorenz KA. Signature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers. Journal Of Pain And Symptom Management 2019, 59: 49-57. PMID: 31476361, DOI: 10.1016/j.jpainsymman.2019.08.020.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyCancer-related painOpioid therapyVeterans Health Administration medical centersInformed consentAppropriate literacy levelPerspectives of patientsPatient-provider relationshipCancer-related concernsOpioid useOpioid prescribersPatient interviewsPatient educationMedical CenterPatientsPainProvider perspectivesTherapyCancerConsentLiteracy levelsProvidersPotential disadvantagesEmergent themesOpioids
2018
An evaluation of the feasibility, acceptability, and preliminary efficacy of cognitive-behavioral therapy for opioid use disorder and chronic pain
Barry DT, Beitel M, Cutter CJ, Fiellin DA, Kerns RD, Moore BA, Oberleitner L, Madden LM, Liong C, Ginn J, Schottenfeld RS. An evaluation of the feasibility, acceptability, and preliminary efficacy of cognitive-behavioral therapy for opioid use disorder and chronic pain. Drug And Alcohol Dependence 2018, 194: 460-467. PMID: 30508769, PMCID: PMC6312460, DOI: 10.1016/j.drugalcdep.2018.10.015.Peer-Reviewed Original ResearchConceptsOpioid use disorderCognitive behavioral therapyChronic painPreliminary efficacyDrug counselingUse disordersImproved pain outcomesProportion of patientsMethadone-maintained patientsNonmedical opioid useEnd of treatmentPrimary study aimPatient satisfaction ratingsManualized cognitive behavioral therapyOpioid usePain outcomesPain interferenceClinical trialsStandard drug counselingPatientsMean sessionSecondary aimStudy aimPainPilot studyOpioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care
Lisi AJ, Corcoran KL, DeRycke EC, Bastian LA, Becker WC, Edmond SN, Goertz CM, Goulet JL, Haskell SG, Higgins DM, Kawecki T, Kerns RD, Mattocks K, Ramsey C, Ruser CB, Brandt CA. Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care. Pain Medicine 2018, 19: s54-s60. PMID: 30203014, DOI: 10.1093/pm/pny114.Peer-Reviewed Original ResearchConceptsOEF/OIF/OND veteransOpioid prescriptionsChiropractic visitsOpioid useChiropractic careOperations Enduring Freedom/Iraqi Freedom/New DawnMore opioid prescriptionsVA chiropractic servicesPercentage of veteransCross-sectional analysisOpioid receiptClinic visitsClinical characteristicsCurrent smokingSevere painChiropractic clinicChiropractic servicesVisitsHigher likelihoodVeteransPrescriptionCareFurther studiesAdministrative dataOne-third
2016
Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars
Bastian LA, Driscoll MA, Heapy AA, Becker WC, Goulet JL, Kerns RD, DeRycke EC, Perez E, Lynch SM, Mattocks K, Kroll-Desrosiers AR, Brandt CA, Skanderson M, Bathulapalli H, Haskell SG. Cigarette Smoking Status and Receipt of an Opioid Prescription Among Veterans of Recent Wars. Pain Medicine 2016, 18: 1089-1097. PMID: 27659441, DOI: 10.1093/pm/pnw223.Peer-Reviewed Original ResearchConceptsCurrent pain intensityOpioid prescriptionsPain intensitySmoking statusOEF/OIF/OND veteransCurrent smokersFormer smokersOpioid useVeterans Health Administration primary care clinicsOperations Enduring Freedom/Iraqi Freedom/New DawnMild pain intensityMore opioid prescriptionsSevere pain intensityNumeric rating scalePrimary care clinicsCigarette smoking statusCross-sectional analysisOpioid receiptFormer smokingCohort studyCurrent smokingCare clinicsChronic painCigarette smokersSmoking cessationNon‐medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study
Banerjee G, Edelman EJ, Barry DT, Becker WC, Cerdá M, Crystal S, Gaither JR, Gordon AJ, Gordon KS, Kerns RD, Martins SS, Fiellin DA, Marshall BD. Non‐medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study. Addiction 2016, 111: 2021-2031. PMID: 27552496, PMCID: PMC5056813, DOI: 10.1111/add.13491.Peer-Reviewed Original ResearchConceptsMultivariable Cox regression modelsNon-medical useCox regression modelHeroin initiationPrescription opioidsHeroin useCohort studyUS veteransOpioid use disorder diagnosisVeterans Aging Cohort StudyProspective cohort studyAging Cohort StudyIllicit opioid usePrimary care clinicsPrimary outcome measureStrong risk factorPost-traumatic stress disorderUninfected veteransUninfected patientsOpioid useRegression modelsCare clinicsPain interferencePrior diagnosisPrimary exposurePrevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer.
Barry DT, Sofuoglu M, Kerns RD, Wiechers IR, Rosenheck RA. Prevalence and correlates of coprescribing anxiolytic medications with extensive prescription opioid use in Veterans Health Administration patients with metastatic cancer. Journal Of Opioid Management 2016, 12: 259-68. PMID: 27575827, DOI: 10.5055/jom.2016.0341.Peer-Reviewed Original ResearchConceptsPrescription opioid useVeterans Health Administration patientsOpioid useMetastatic cancerAnxiolytic medicationMedical indicationsMultivariate analysisMore emergency department visitsNational VHA dataEmergency department visitsPrescription of antidepressantsAnxiolytic prescriptionsOpioid prescriptionsDepartment visitsVHA patientsPsychotropic medicationsFiscal year 2012VHA dataDrug AdministrationMedicationsBipolar disorderCareful monitoringYounger ageAnxiolyticsCancerNational Action Plan for Adverse Drug Event Prevention: Recommendations for Safer Outpatient Opioid Use
Ducoffe AR, York A, Hu DJ, Perfetto D, Kerns RD. National Action Plan for Adverse Drug Event Prevention: Recommendations for Safer Outpatient Opioid Use. Pain Medicine 2016, 17: 2291-2304. PMID: 28025363, PMCID: PMC6280931, DOI: 10.1093/pm/pnw106.Peer-Reviewed Original ResearchConceptsAdverse drug eventsAdverse drug event preventionOpioid useEvent preventionOutpatient opioid prescriptionsOutpatient opioid useSafe opioid usePublic health challengeEvidence-based preventionADE preventionOpioid prescriptionsHealthcare delivery settingsDiabetes agentsDrug eventsDrug classesHealth promotionHealthcare providersDisease preventionHealth challengesPatient safetyDelivery settingsPreventionNational Action PlanAction planAdditional research
2015
Combined Use of Opioids and Antidepressants in the Treatment of Pain: A Review of Veterans Health Administration Data for Patients with Pain Both With and Without Co-morbid Depression
Sellinger JJ, Sofuoglu M, Kerns RD, Rosenheck RA. Combined Use of Opioids and Antidepressants in the Treatment of Pain: A Review of Veterans Health Administration Data for Patients with Pain Both With and Without Co-morbid Depression. Psychiatric Quarterly 2015, 87: 585-593. PMID: 26646578, DOI: 10.1007/s11126-015-9411-1.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationMusculoskeletal painAntidepressant useVeterans Health Administration dataAnnual opioid prescriptionsNational VHA databasesUse of antidepressantsCo-morbid depressionTreatment of painHealth Administration dataMajor depressive disorderNon-depressed groupOpioid therapyAnalgesic benefitOpioid prescribingOpioid prescriptionsPrescribing patternsOpioid useVHA databasesFiscal year 2012Depressive disorderDepression diagnosisPainAntidepressantsOpioidsReceipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care
Kroll-Desrosiers AR, Skanderson M, Bastian LA, Brandt CA, Haskell S, Kerns RD, Mattocks KM. Receipt of Prescription Opioids in a National Sample of Pregnant Veterans Receiving Veterans Health Administration Care. Women's Health Issues 2015, 26: 240-246. PMID: 26549242, DOI: 10.1016/j.whi.2015.09.010.Peer-Reviewed Original ResearchConceptsPrescription opioid usePregnancy windowsOpioid prescriptionsPsychiatric diagnosisWomen veteransPregnant veteransOpioid usePrescription opioidsVeterans Health Administration (VHA) careMultivariable logistic regression modelVeterans Health Administration (VHA) servicesNontraumatic joint disordersPain management strategiesHealth-related variablesLogistic regression modelsPhysical health variablesPotential undertreatmentVHA servicesJoint disordersVHA systemOperation Enduring FreedomBack problemsOpioidsHealth variablesNational database