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
Fall-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
Temporal and Geographic Patterns of Documentation of Sexual Orientation and Gender Identity Keywords in Clinical Notes
Workman T, Goulet J, Brandt C, Lindemann L, Skanderson M, Warren A, Eleazer J, Kronk C, Gordon K, Pratt-Chapman M, Zeng-Treitler Q. Temporal and Geographic Patterns of Documentation of Sexual Orientation and Gender Identity Keywords in Clinical Notes. Medical Care 2022, 61: 130-136. PMID: 36511399, PMCID: PMC9931630, DOI: 10.1097/mlr.0000000000001803.Peer-Reviewed Original ResearchJoint 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 ResearchMeSH KeywordsAnalgesics, OpioidBenzodiazepinesDementiaHumansUnited StatesUnited States Department of Veterans AffairsVeteransConceptsCommunity 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 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 survivorsWomenDiagnosisTraumaVeteransDocumentation 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
Exploring supervised machine learning approaches to predicting Veterans Health Administration chiropractic service utilization
Coleman BC, Fodeh S, Lisi AJ, Goulet JL, Corcoran KL, Bathulapalli H, Brandt CA. Exploring supervised machine learning approaches to predicting Veterans Health Administration chiropractic service utilization. Chiropractic & Manual Therapies 2020, 28: 47. PMID: 32680545, PMCID: PMC7368704, DOI: 10.1186/s12998-020-00335-4.Peer-Reviewed Original ResearchConceptsSpinal pain conditionsService utilizationPain conditionsChiropractic careConservative interventionsChiropractic servicesVA chiropractic servicesRetrospective cohort studyHealthcare service utilizationHealthcare cost burdenLimited clinical utilityLower healthcare costsCohort entryCohort studyDiagnosis cohortPain statusPrimary outcomeChiropractic visitsClinical featuresUS adultsClinical utilityHealthcare costsDifferent clinical populationsVisitsClinical populationsSex Differences in Military Sexual Trauma and Severe Self-Directed Violence
Gross GM, Ronzitti S, Combellick JL, Decker SE, Mattocks KM, Hoff RA, Haskell SG, Brandt CA, Goulet JL. Sex Differences in Military Sexual Trauma and Severe Self-Directed Violence. American Journal Of Preventive Medicine 2020, 58: 675-682. PMID: 32037020, DOI: 10.1016/j.amepre.2019.12.006.Peer-Reviewed Original ResearchConceptsMilitary sexual traumaSelf-directed violenceSexual traumaWomen veteransCox proportional hazards regression modelVeterans Health Administration (VHA) careProportional hazards regression modelsHazards regression modelsOperations Enduring Freedom/Iraqi Freedom/New Dawn veteransPsychiatric morbidityNew Dawn veteransSuicide attemptsBivariate analysisPreventative effortsTraumaWomenMenSex differencesVeteransRiskRegression modelsDemographic variablesSevere selfHospitalizationMorbidity
2019
Screening 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 characteristicsDepression and all‐cause mortality risk in HIV‐infected and HIV‐uninfected US veterans: a cohort study
So‐Armah K, Gupta S, Kundu S, Stewart J, Goulet J, Butt A, Sico J, Marconi, Crystal S, Rodriguez‐Barradas M, Budoff M, Gibert C, Chang C, Bedimo R, Freiberg. Depression and all‐cause mortality risk in HIV‐infected and HIV‐uninfected US veterans: a cohort study. HIV Medicine 2019, 20: 317-329. PMID: 30924577, PMCID: PMC6459698, DOI: 10.1111/hiv.12726.Peer-Reviewed Original ResearchConceptsHIV infectionMajor depressive disorderHIV statusDepressive symptomsMedian followCause mortalityDepressive disorderMortality riskVeterans Aging Cohort Study (VACS) dataDeath rateMajor depressive disorder diagnosisFirst clinic visitCause mortality riskPHQ-9 scoresNinth Revision codesPatient Health QuestionnaireDepressive disorder diagnosisPHQ-9 dataCohort study dataContribution of depressionDepression definitionsClinic visitsCohort studyComorbid conditionsEligible participants
2018
Dual Use of Department of Veterans Affairs and Medicare Benefits on High‐Risk Opioid Prescriptions in Veterans Aged 65 Years and Older: Insights from the VA Musculoskeletal Disorders Cohort
Chui PW, Bastian LA, DeRycke E, Brandt CA, Becker WC, Goulet JL. Dual Use of Department of Veterans Affairs and Medicare Benefits on High‐Risk Opioid Prescriptions in Veterans Aged 65 Years and Older: Insights from the VA Musculoskeletal Disorders Cohort. Health Services Research 2018, 53: 5402-5418. PMID: 30298672, PMCID: PMC6235820, DOI: 10.1111/1475-6773.13060.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationOpioid prescriptionsHigh-risk opioid prescriptionsLong-term opioid therapyLong-term opioid useMultivariable logistic regressionMusculoskeletal disorder diagnosisMSD cohortOpioid therapyClinical characteristicsOpioid useVHA dataRetrospective analysisHealth AdministrationNational MedicareDisorder cohortDual useLogistic regressionDisorder diagnosisMedicareMedicare benefitsVeteransPrescriptionCohortAssociationOpioid 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-thirdProject STEP: Implementing the Veterans Health Administration’s Stepped Care Model of Pain Management
Edmond SN, Moore BA, Dorflinger LM, Goulet JL, Becker WC, Heapy AA, Sellinger JJ, Lee AW, Levin FL, Ruser CB, Kerns RD. Project STEP: Implementing the Veterans Health Administration’s Stepped Care Model of Pain Management. Pain Medicine 2018, 19: s30-s37. PMID: 30203015, DOI: 10.1093/pm/pny094.Peer-Reviewed Original ResearchConceptsVA Connecticut Healthcare SystemPrimary care providersVeterans Health AdministrationPain careStepped care modelCare providersPain managementCare modelHealth care utilization dataMultimodal pain careNonopioid analgesic prescribingLong-term opioidsElectronic health record dataPain intensity ratingsHealth record dataClinical health psychologyNonpharmacological servicesAnalgesic prescribingOpioid prescribingPharmacological managementNonpharmacological approachesNonpharmacological treatmentsReferral practicesPhysical therapyCare practices