2021
Who Uses Veterans Mental Health Services?
Manhapra A, Stefanovics EA, Rhee TG, Rosenheck RA. Who Uses Veterans Mental Health Services? The Journal Of Nervous And Mental Disease 2021, 209: 702-709. PMID: 33993183, DOI: 10.1097/nmd.0000000000001369.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationPosttraumatic stress disorderHealth service usersMH service usersSubstance use disorder diagnosisClinical practice guidelinesMental health servicesMental health service usersClinical characteristicsMedicaid insurancePain interferenceService usersBlack raceSimilar prevalenceMental health researchMH researchPractice guidelinesGreater prevalenceHealth AdministrationHealth servicesPTSD diagnosisRacial distributionMH statusStress disorderDisorder diagnosis
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 mortalityPLWHMortalityHIVPatientsDoseAssociations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation
Oliva E, Bowe T, Manhapra A, Kertesz S, Hah J, Henderson P, Robinson A, Paik M, Sandbrink F, Gordon A, Trafton J. Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation. The BMJ 2020, 368: m283. PMID: 32131996, PMCID: PMC7249243, DOI: 10.1136/bmj.m283.Peer-Reviewed Original ResearchConceptsLength of treatmentVeterans Health AdministrationOpioid treatmentHealth AdministrationLong patientsObservational evaluationRisk of deathHazards regression modelsFocus of guidelinesLong-term useOpioid cessationOpioid prescriptionsOpioid analgesicsOutpatient prescriptionsPlace patientsSafe prescribingPatient deathUS veteransNon-proportional hazards regression modelsPatient's perspectiveFiscal year 2014OpioidsPatientsOverdoseGreater risk
2019
High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans.
Banerjee G, Edelman EJ, Barry DT, Crystal S, Gordon KS, Gordon AJ, Gaither JR, Green TC, Kerns RD, Manhapra A, Moore BA, Fiellin DA, Marshall BDL. High-dose prescribed opioids are associated with increased risk of heroin use among United States military veterans. Pain 2019, 160: 2126-2135. PMID: 31145217, PMCID: PMC6699915, DOI: 10.1097/j.pain.0000000000001606.Peer-Reviewed Original ResearchConceptsHigh-dose opioid prescriptionsOpioid prescriptionsHeroin useCohort studyPrior receiptHepatitis C virus (HCV) infection statusLong-term opioid prescriptionsPast-year heroin useVeterans Aging Cohort StudyHigh-dose opioidsOpioid-prescribing patternsProspective cohort studyAging Cohort StudyOpioid use disorderCurrent national guidelinesUnhealthy alcohol useUnited States veteransUnited States military veteransVirus infection statusPosttraumatic stress disorderOpioid receiptPrescribed opioidsPain interferenceCox regressionStates veterans
2018
Multimodal Treatment Options, Including Rotating to Buprenorphine, Within a Multidisciplinary Pain Clinic for Patients on Risky Opioid Regimens: A Quality Improvement Study
Oldfield BJ, Edens EL, Agnoli A, Bone CW, Cervone DJ, Edmond SN, Manhapra A, Sellinger JJ, Becker WC. Multimodal Treatment Options, Including Rotating to Buprenorphine, Within a Multidisciplinary Pain Clinic for Patients on Risky Opioid Regimens: A Quality Improvement Study. Pain Medicine 2018, 19: s38-s45. PMID: 30203007, DOI: 10.1093/pm/pny086.Peer-Reviewed Original ResearchConceptsPrimary care providersIntake appointmentMorphine equivalent daily dosePartial opioid agonist buprenorphineVeterans Health Administration hospitalsPartial agonist therapiesPrescribed opioid dosesRetrospective cohort studyUnsafe useEquivalent daily doseMultidisciplinary pain clinicMultimodal treatment optionsChronic pain managementPrimary care settingQuality improvement studyHealth system levelHealth system improvementOpioid dosesCohort studyPain clinicDaily doseOpioid regimensPain managementMultidisciplinary clinicTreatment options
2017
Evaluation of an Integrated, Multidisciplinary Program to Address Unsafe Use of Opioids Prescribed for Pain
Becker WC, Edmond SN, Cervone DJ, Manhapra A, Sellinger JJ, Moore BA, Edens EL. Evaluation of an Integrated, Multidisciplinary Program to Address Unsafe Use of Opioids Prescribed for Pain. Pain Medicine 2017, 19: 1419-1424. PMID: 28371816, DOI: 10.1093/pm/pnx041.Peer-Reviewed Original ResearchConceptsPreliminary efficacyUnsafe useSubstance abuse/dependenceMultidisciplinary care teamSubstance use disorder diagnosisPrimary care physiciansAdvanced practice nursesUrine drug testingLength of treatmentStructured clinical assessmentNurse case managersAbuse/dependenceHealth system levelHigh-complexity patientsElectronic progress notesOpioid prescribedOpioid receiptCare physiciansPractice nursesPrimary careCare coordinationCare teamClinical assessmentCare modelClinic processes
2013
Early accelerated senescence of circulating endothelial progenitor cells in premature coronary artery disease patients in a developing country - a case control study
Vemparala K, Roy A, Bahl V, Prabhakaran D, Nath N, Sinha S, Nandi P, Pandey R, Reddy K, Manhapra A, Lakshmy R. Early accelerated senescence of circulating endothelial progenitor cells in premature coronary artery disease patients in a developing country - a case control study. BMC Cardiovascular Disorders 2013, 13: 104. PMID: 24245738, PMCID: PMC3871012, DOI: 10.1186/1471-2261-13-104.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseEndothelial progenitor cellsPCAD patientsVascular cell senescencePremature CADVascular senescenceEvidence of CADPremature coronary artery disease patientsNumber of EPCsCoronary artery disease patientsPremature coronary artery diseaseProgenitor cellsCase-control studyCell senescenceYears of ageReal-time polymerase chain reactionTime polymerase chain reactionCAD epidemicEPC senescenceYounger patientsArtery diseaseDisease patientsPolymerase chain reactionRandom patientsIndia Institute
2007
Differences in the prevalence of metabolic syndrome in urban and rural India: a problem of urbanization
Prabhakaran D, Chaturvedi V, Shah P, Manhapra A, Jeemon P, Shah B, Srinath Reddy K. Differences in the prevalence of metabolic syndrome in urban and rural India: a problem of urbanization. Chronic Illness 2007, 3: 8-19. PMID: 18072694, DOI: 10.1177/1742395307079197.Peer-Reviewed Original Research
2005
Sex and Racial Differences in the Management of Acute Myocardial Infarction, 1994 through 2002
Vaccarino V, Rathore SS, Wenger NK, Frederick PD, Abramson JL, Barron HV, Manhapra A, Mallik S, Krumholz HM. Sex and Racial Differences in the Management of Acute Myocardial Infarction, 1994 through 2002. New England Journal Of Medicine 2005, 353: 671-682. PMID: 16107620, PMCID: PMC2805130, DOI: 10.1056/nejmsa032214.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAspirinBlack PeopleCoronary AngiographyFemaleHealth Services AccessibilityHospital MortalityHumansLogistic ModelsMaleMiddle AgedMyocardial InfarctionMyocardial RevascularizationPlatelet Aggregation InhibitorsProcess Assessment, Health CareQuality of Health CareRisk FactorsSex FactorsUnited StatesWhite PeopleConceptsUse of aspirinMyocardial infarctionReperfusion therapyCoronary angiographyRacial differencesTreatment of patientsHospital deathHospital mortalityMultivariable adjustmentUnadjusted analysesNational registryInfarctionWhite womenAspirinAngiographyTherapyWhite menSexPatientsBlack womenSex differencesParticular treatmentBlack menWomenDeathCardiovascular risk factor prevalence among men in a large industry of northern India.
Prabhakaran D, Shah P, Chaturvedi V, Ramakrishnan L, Manhapra A, Reddy K. Cardiovascular risk factor prevalence among men in a large industry of northern India. The National Medical Journal Of India 2005, 18: 59-65. PMID: 15981439.Peer-Reviewed Original ResearchConceptsCVD risk factorsCoronary heart diseaseRisk factorsCardiovascular diseaseMetabolic syndromeHeart diseaseCardiovascular risk factor prevalenceMajor CVD risk factorsPrevalence of CVDLarge industrial populationRisk factor burdenCardiovascular risk profileHistory of strokeImpaired glucose toleranceRose angina questionnaireRisk factor prevalenceYoung male populationYears of ageCross-sectional surveyStatus of awarenessHypertension 30Angina QuestionnaireCentral obesityBlood pressureFactor prevalence
2004
Relation of age and race with hospital death after acute myocardial infarction
Manhapra A, Canto J, Vaccarino V, Parsons L, Kiefe C, Barron H, Rogers W, Weaver W, Borzak S. Relation of age and race with hospital death after acute myocardial infarction. American Heart Journal 2004, 148: 92-98. PMID: 15215797, DOI: 10.1016/j.ahj.2004.02.010.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHospital mortality rateHigher hospital mortality rateShort-term deathHospital deathMortality rateClinical presentationBlack raceMyocardial infarctionHospital characteristicsRelation of ageEarly treatmentAdjusted hospital mortality ratesHigher crude mortality rateMyocardial Infarction 2Overall crude mortalityCrude mortality rateInfluence of ageCrude mortalityAMI populationNational registryHigher oddsHigh riskUS hospitalsAge groups
2001
Underutilization of reperfusion therapy in eligible African Americans with acute myocardial infarction: Role of presentation and evaluation characteristics
Manhapra A, Canto J, Barron H, Malmgren J, Taylor H, Rogers W, Weaver W, Every N, Borzak S. Underutilization of reperfusion therapy in eligible African Americans with acute myocardial infarction: Role of presentation and evaluation characteristics. American Heart Journal 2001, 142: 604-610. PMID: 11579349, DOI: 10.1067/mhj.2001.118464.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAngioplastyBlack or African AmericanComorbidityCoronary Artery BypassFemaleHeart FailureHospitalizationHumansMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionMyocardial ReperfusionPatient SelectionProspective StudiesRegistriesStrokeThrombolytic TherapyTime FactorsTreatment OutcomeConceptsAcute myocardial infarctionReperfusion therapyMyocardial infarctionAfrican AmericansImmediate reperfusion therapyMyocardial Infarction 2Early reperfusion therapyCongestive heart failureCoronary blood flowDefinite myocardial infarctionAfrican American patientsEligible patientsPrior strokeChest painHospital arrivalInitial admissionRate of useAtypical presentationEarly reperfusionHeart failureMean ageAmerican patientsNational registryCare providersBlood flow
2000
Electrocardiographic presentation of blacks with first myocardial infarction does not explain race differences in thrombolysis administration
Manhapra A, Khaja F, Syed M, Rybicki B, Wulbrecht N, Alam M, Sabbah H, Goldstein S, Borzak S. Electrocardiographic presentation of blacks with first myocardial infarction does not explain race differences in thrombolysis administration. American Heart Journal 2000, 140: 200-205. PMID: 10925330, DOI: 10.1067/mhj.2000.107173.Peer-Reviewed Original ResearchConceptsElectrocardiographic presentationThrombolysis administrationFirst myocardial infarctionBundle branch blockConditional logistic regressionST-segment deviationFirst MIInitial electrocardiogramConsecutive patientsClinical presentationClinical variablesMyocardial infarctionBranch blockThrombolysisGreater prevalenceElectrocardiographic manifestationsLogistic regressionMyocardial infarction (MI) accountUnmeasured differencesRacial differencesSimilar proportionsFurther studiesEligibilityAdministrationPresentation