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
Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools
Piette JD, Newman S, Krein SL, Marinec N, Chen J, Williams DA, Edmond SN, Driscoll M, LaChappelle KM, Kerns RD, Maly M, Kim HM, Farris KB, Higgins DM, Buta E, Heapy AA. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools. JAMA Internal Medicine 2022, 182: 975-983. PMID: 35939288, PMCID: PMC9361183, DOI: 10.1001/jamainternmed.2022.3178.Peer-Reviewed Original ResearchConceptsCBT-CPComparative effectiveness trialTherapist timeSecondary outcomesMore patientsEffectiveness trialInteractive voice responseCP groupMeaningful improvementsPatient-centered pain careRoland-Morris Disability QuestionnaireVeterans Affairs Health SystemMorris Disability QuestionnairePain intensity scoresChronic back painLess therapist timeMobile health toolsCognitive behavioral therapyRandomized noninferiorityDisability QuestionnaireNoninferiority criteriaOpioid analgesicsPain intensityPain therapyPrimary outcomeAssociation Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy
Black AC, Zeliadt SB, Kerns RD, Skanderson M, Wang R, Gelman H, Douglas JH, Becker WC. Association Between Exposure to Complementary and Integrative Therapies and Opioid Analgesic Daily Dose Among Patients on Long-term Opioid Therapy. The Clinical Journal Of Pain 2022, 38: 405-409. PMID: 35440528, DOI: 10.1097/ajp.0000000000001039.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyMorphine equivalent daily doseVeterans Health AdministrationDaily doseCIH exposureOpioid doseOpioid therapyWhole health systemCIH useVHA electronic health recordsIntegrative health modalitiesOpioid analgesic doseMean starting doseMental health diagnosesElectronic health recordsAnalgesic doseCIH therapiesNonopioid treatmentCohort entryOpioid taperingStarting doseAdverse eventsPain intensityChiropractic careVHA facilitiesTaking ACTION to Reduce Pain: a Randomized Clinical Trial of a Walking-Focused, Proactive Coaching Intervention for Black Patients with Chronic Musculoskeletal Pain
Burgess DJ, Hagel Campbell E, Hammett P, Allen KD, Fu SS, Heapy A, Kerns RD, Krein SL, Meis LA, Bangerter A, Cross LJS, Do T, Saenger M, Taylor BC. Taking ACTION to Reduce Pain: a Randomized Clinical Trial of a Walking-Focused, Proactive Coaching Intervention for Black Patients with Chronic Musculoskeletal Pain. Journal Of General Internal Medicine 2022, 37: 3585-3593. PMID: 35132545, PMCID: PMC9585120, DOI: 10.1007/s11606-021-07376-2.Peer-Reviewed Original ResearchConceptsBlack patientsUsual careSecondary outcomesPain intensityPrimary outcomeChronic painIntervention participantsVA health care systemMasked outcome assessmentChronic musculoskeletal painMental health comorbiditiesChronic pain outcomesAverage daily stepsTelephone coaching sessionsMain MeasuresPrimary outcomesCoaching interventionHealth care systemResultsThe interventionHealth comorbiditiesMusculoskeletal painPain outcomesSevere chronicPain interferenceGlobal ImpressionMeasuresPrimary outcomes
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 visitsPain, Complex Chronic Conditions and Potential Inappropriate Medication in People with Dementia. Lessons Learnt for Pain Treatment Plans Utilizing Data from the Veteran Health Administration
Husebo BS, Kerns RD, Han L, Skanderson M, Gnjidic D, Allore HG. Pain, Complex Chronic Conditions and Potential Inappropriate Medication in People with Dementia. Lessons Learnt for Pain Treatment Plans Utilizing Data from the Veteran Health Administration. Brain Sciences 2021, 11: 86. PMID: 33440668, PMCID: PMC7827274, DOI: 10.3390/brainsci11010086.Peer-Reviewed Original ResearchChronic complex conditionsSevere pain intensityVeterans Health AdministrationPain intensityHealth AdministrationDiscontinuation of opioidsInappropriate pain managementPain treatment planPotential inappropriate medicationsInappropriate medication useComplex chronic conditionsNon-pharmacological approachesImportant risk factorAdverse drug reactionsFinal analytic sampleAnalgesic efficacyInappropriate medicationsOpioid medicationsPain medicationMedication usePain managementPersistent painChronic painMedical illnessOutpatient visits
2020
The Relationship Between Body Mass Index and Pain Intensity Among Veterans with Musculoskeletal Disorders: Findings from the MSD Cohort Study
Higgins DM, Buta E, Heapy AA, Driscoll MA, Kerns RD, Masheb R, Becker WC, Hausmann LRM, Bair MJ, Wandner L, Janke EA, Brandt CA, Goulet JL. The Relationship Between Body Mass Index and Pain Intensity Among Veterans with Musculoskeletal Disorders: Findings from the MSD Cohort Study. Pain Medicine 2020, 21: 2563-2572. PMID: 32186722, PMCID: PMC7778330, DOI: 10.1093/pm/pnaa043.Peer-Reviewed Original ResearchConceptsBody mass indexVeterans Health AdministrationPain intensityMass indexFunction of BMILow back pain groupOdds of painBack pain groupOverweight/obesityElectronic health record dataHealth record dataUS military veteransMusculoskeletal disorder diagnosisCohort studyOsteoarthritis groupPain groupMean ageNational cohortHigh prevalenceMSD diagnosisMusculoskeletal disordersPainHealth AdministrationDisorder diagnosisCross-sectional dataInternet‐Based Pain Self‐Management for Veterans: Feasibility and Preliminary Efficacy of the Pain EASE Program
Higgins DM, Buta E, Williams DA, Halat A, Bair MJ, Heapy AA, Krein SL, Rajeevan H, Rosen MI, Kerns RD. Internet‐Based Pain Self‐Management for Veterans: Feasibility and Preliminary Efficacy of the Pain EASE Program. Pain Practice 2020, 20: 357-370. PMID: 31778281, DOI: 10.1111/papr.12861.Peer-Reviewed Original ResearchConceptsChronic low back painSelf-management programPain interferencePreliminary efficacyInternet-based self-management programPhase IPost-baseline assessmentLow back painPain Self-ManagementPhase IIPreliminary efficacy studyTechnology-delivered interventionsModerate painSecondary outcomesPain intensityBack painAverage ageEfficacy studiesDepression symptomsSubject improvementExpert panelSelf-ManagementSubject changesEASE programWeeks
2019
Personal Resource Profiles of Individuals With Chronic Pain: Sociodemographic and Pain Interference Differences
Mun CJ, Davis MC, Molton IR, Karoly P, Suk HW, Ehde DM, Tennen H, Kerns RD, Jensen MP. Personal Resource Profiles of Individuals With Chronic Pain: Sociodemographic and Pain Interference Differences. Rehabilitation Psychology 2019, 64: 245-262. PMID: 30688480, PMCID: PMC6737933, DOI: 10.1037/rep0000261.Peer-Reviewed Original ResearchConceptsPain interferenceChronic painChronic pain conditionsSubgroup of individualsPain conditionsPain intensityPain acceptanceBaseline differencesSleep qualityDepressive symptomsNeuromuscular diseasePainPersonal resource variablesAnnual income levelSociodemographic differencesDaily diariesImportant associationGroup differencesSubgroupsFibromyalgiaRobust associationSocial supportLatent profile analysisBaselinePresent studyAnalgesic prescribing trends in a national sample of older veterans with osteoarthritis
Trentalange M, Runels T, Bean A, Kerns RD, Bair MJ, Brody AA, Brandt CA, Hwang U. Analgesic prescribing trends in a national sample of older veterans with osteoarthritis. Pain 2019, Publish Ahead of Print: &na;. PMID: 30913167, PMCID: PMC9486693, DOI: 10.1097/j.pain.0000000000001509.Peer-Reviewed Original ResearchConceptsPain intensity ratingsAnalgesic prescriptionPrescribing trendsOlder veteransIntensity ratingsNonopioid analgesic prescribingPatterns of opioidPre-post observational studyReported pain intensityInterrupted time seriesOlder U.S. veteransAcetaminophen prescriptionsAnalgesic classTotal prescribingAnalgesic prescribingOpioid prescribingPain intensityDrug prescribingObservational studyPrescribingU.S. veteransPrescribing programmeOsteoarthritisStudy periodBinomial regression modelsCore Outcome Measures for Chronic Musculoskeletal Pain Research: Recommendations from a Veterans Health Administration Work Group
Kroenke K, Krebs EE, Turk D, Von Korff M, Bair MJ, Allen KD, Sandbrink F, Cheville AL, DeBar L, Lorenz KA, Kerns RD. Core Outcome Measures for Chronic Musculoskeletal Pain Research: Recommendations from a Veterans Health Administration Work Group. Pain Medicine 2019, 20: 1500-1508. PMID: 30615172, DOI: 10.1093/pm/pny279.Peer-Reviewed Original ResearchMeSH KeywordsAnxietyBiomedical ResearchChronic PainDelphi TechniqueDepressionHumansMusculoskeletal PainOutcome Assessment, Health CarePain ManagementPain MeasurementPatient Health QuestionnairePatient Reported Outcome MeasuresPhysical Functional PerformancePsychometricsSleepUnited StatesUnited States Department of Veterans AffairsConceptsCore Outcome MeasuresOutcome measuresPain intensityPatient-reported global impressionBrief Pain Inventory Interference ScaleChronic musculoskeletal pain disordersMusculoskeletal pain disordersChronic musculoskeletal painPatient Health QuestionnaireNumerical rating scaleVeterans Health AdministrationCommon outcome measuresGeneralized anxiety disorderMusculoskeletal painPain disordersChronic painGlobal ImpressionPhysical functionHealth QuestionnairePhysical functioningSleep ScaleDepression ScaleOutcomes Information SystemPain researchHealth Administration
2018
A Brief, Integrated, Telephone-Based Intervention for Veterans Who Smoke and Have Chronic Pain: A Feasibility Study
Driscoll MA, Perez E, Edmond SN, Becker WC, DeRycke EC, Kerns RD, Bastian LA. A Brief, Integrated, Telephone-Based Intervention for Veterans Who Smoke and Have Chronic Pain: A Feasibility Study. Pain Medicine 2018, 19: s84-s92. PMID: 30203011, DOI: 10.1093/pm/pny144.Peer-Reviewed Original ResearchConceptsChronic painEvidence-based smoking cessationWorst pain intensity scorePain intensity scoresTelephone-delivered interventionChronic pain reportVA healthcare systemCo-occurring smokingCurrent smokingPain intensityPain outcomesSmoking cessationTelephone interventionPrimary carePain reportsVeteran populationSmokingIntensity scoresMeaningful improvementsStudy participantsPilot studyFunctional interferenceHealthcare systemInterventionPainImpact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C
Lynch SM, Wilson SM, DeRycke EC, Driscoll MA, Becker WC, Goulet JL, Kerns RD, Mattocks KM, Brandt CA, Bathulapalli H, Skanderson M, Haskell SG, Bastian LA. Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C. Pain Medicine 2018, 19: s5-s11. PMID: 30203017, DOI: 10.1093/pm/pny146.Peer-Reviewed Original ResearchConceptsHepatitis C virusSevere pain intensityPain intensityElectronic medical recordsCurrent smokersSmoking statusVeterans Health Administration primary care clinicsOperations Enduring Freedom/Iraqi Freedom/New DawnIndependent risk factorInteraction of smokingNumeric rating scalePrimary care clinicsHigher pain intensityCigarette smoking statusICD-9 codesOEF/OIF/OND veteransCross-sectional analysisCohort studyCurrent smokingHepatitis C.Severe painPain managementTobacco smokingCare clinicsChronic painEvaluation 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 effectivenessIntervention Mapping to develop a Social Cognitive Theory-based intervention for chronic pain tailored to individuals with HIV
Merlin JS, Young SR, Johnson MO, Saag M, Demonte W, Kerns R, Bair MJ, Kertesz S, Turan JM, Kilgore M, Clay OJ, Pekmezi D, Davies S. Intervention Mapping to develop a Social Cognitive Theory-based intervention for chronic pain tailored to individuals with HIV. Contemporary Clinical Trials Communications 2018, 10: 9-16. PMID: 29696153, PMCID: PMC5898474, DOI: 10.1016/j.conctc.2018.02.004.Peer-Reviewed Original ResearchSocial cognitive theoryCognitive theoryChronic painBehavioral interventionsIntervention MappingIntervention mapping processChronic pain outcomesHIV primary care clinicPain-related functional impairmentNon-pharmacologic interventionsPrimary care clinicsIntervention effectsTheoretical constructsBehavioral sciencesImportant comorbidityPain intensityPain outcomesCare clinicsProximal mediatorQualitative findingsFunctional impairmentConceptual frameworkGeneral populationUnique needsIntervention impact
2017
Nationwide Implementation and Outcomes of Cognitive Behavioral Therapy for Chronic Pain Over Clinical Video Teleconferencing
Connolly K, Vanderploeg P, Kerns R, Grant C, Sellinger J, Godleski L. Nationwide Implementation and Outcomes of Cognitive Behavioral Therapy for Chronic Pain Over Clinical Video Teleconferencing. Journal Of Technology In Behavioral Science 2017, 3: 26-31. DOI: 10.1007/s41347-017-0024-4.Peer-Reviewed Original ResearchClinical video teleconferencingVeterans Health AdministrationChronic painCognitive behavioral therapyCBT-CPBehavioral therapyElectronic medical recordsElectronic medical record systemMedical record systemPain intensityPain diagnosisCapitated payment systemMedical recordsTreatment appointmentsTherapy appointmentsDaily livingHealth AdministrationStudy reporting resultsPainTelehealth servicesTelehealth technologyLicensure restrictionsSample t-testNationwide implementationHealthcare systemDeveloping a typology of patient-generated behavioral goals for cognitive behavioral therapy for chronic pain (CBT-CP): classification and predicting outcomes
Heapy AA, Wandner L, Driscoll MA, LaChappelle K, Czlapinski R, Fenton BT, Piette JD, Aikens JE, Janevic MR, Kerns RD. Developing a typology of patient-generated behavioral goals for cognitive behavioral therapy for chronic pain (CBT-CP): classification and predicting outcomes. Journal Of Behavioral Medicine 2017, 41: 174-185. PMID: 28936717, DOI: 10.1007/s10865-017-9885-4.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyChronic painYard workTreatment outcomesPhysical activityDepressive symptomsPain-related interferenceWork/schoolPain intensityFunctional statusTreatment goalsPredicting OutcomePatient valuesMeaningful improvementsOutcome domainsBehavioral therapyWellness goalsRecreational activitiesPainTherapyOutcomesSymptomsBehavioral goalsActivityGender 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
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 cessationCooperative pain education and self-management (COPES): study design and protocol of a randomized non-inferiority trial of an interactive voice response-based self-management intervention for chronic low back pain
Heapy AA, Higgins DM, LaChappelle KM, Kirlin J, Goulet JL, Czlapinski RA, Buta E, Piette JD, Krein SL, Richardson CR, Kerns RD. Cooperative pain education and self-management (COPES): study design and protocol of a randomized non-inferiority trial of an interactive voice response-based self-management intervention for chronic low back pain. BMC Musculoskeletal Disorders 2016, 17: 85. PMID: 26879051, PMCID: PMC4754867, DOI: 10.1186/s12891-016-0924-z.Peer-Reviewed Original ResearchConceptsChronic low back painLow back painNon-inferiority trialRandomized non-inferiority trialCognitive behavioral therapyPerson cognitive-behavioural therapyBack painClinical outcomesChronic pain conditionsNumeric rating scalePain-related interferencePatient-reported informationSelf-management interventionsEvidence-based treatmentsQuality of lifeUS military veteransStatewide health systemBackgroundThe InstituteIVR monitoringSecondary outcomesMore patientsPain conditionsPain intensityPrimary outcomeChronic pain