2022
Intervention Fidelity in Pain Pragmatic Trials for Nonpharmacologic Pain Management: Nuanced Considerations for Determining PRECIS-2 Flexibility in Delivery and Adherence
Kerns R, Davis A, Fritz J, Keefe F, Peduzzi P, Rhon D, Taylor S, Vining R, Yu Q, Zeliadt S, George S. Intervention Fidelity in Pain Pragmatic Trials for Nonpharmacologic Pain Management: Nuanced Considerations for Determining PRECIS-2 Flexibility in Delivery and Adherence. Journal Of Pain 2022, 24: 568-574. PMID: 36574858, PMCID: PMC10079571, DOI: 10.1016/j.jpain.2022.12.008.Peer-Reviewed Original ResearchConceptsPragmatic clinical trialsDelivery of interventionsClinical trialsNonpharmacologic pain managementPain management strategiesRoutine clinical settingPain managementNonpharmacological treatmentsRoutine careNonpharmacological interventionsPragmatic trialIntervention core componentsProvider trainingReal-world settingClinical settingIntervention fidelityTreatment flexibilityTrialsInterventionTreatment effectsDegree of pragmatismImplementation barriersAdherenceIntervention monitoringDeliveryLong-term Opioid Therapy and Overdose in Patients with and without Cancer
Merlin J, Black A, Midboe A, Troszak L, Asch S, Bohnert A, Fenton B, Giannitrapani K, Glassman P, Kerns R, Silveira M, Lorenz K, Becker W. Long-term Opioid Therapy and Overdose in Patients with and without Cancer. Journal Of Pain 2022, 23: 60. DOI: 10.1016/j.jpain.2022.03.225.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyCox proportional hazard modelingElectronic health record databaseCancer pain managementRetrospective cohort studyProportional hazard modelingOpioid overdose riskHealth record databasePresence of cancerRole of cancerOpioid receiptCohort entryCohort studyHazard ratioMost patientsPain managementOpioid risksDose/Inclusion criteriaOpioid overdoseOverdose riskLatent growth mixture modelingLower riskPatientsEngaging Veterans and Military Service Members to Optimize Pragmatic Clinical Trials of Nonpharmacological Approaches for Pain Management
Anicich A, Katsovich L, Kerns RD. Engaging Veterans and Military Service Members to Optimize Pragmatic Clinical Trials of Nonpharmacological Approaches for Pain Management. Pain Medicine 2022, 23: pnac020-. PMID: 35143672, PMCID: PMC9425849, DOI: 10.1093/pm/pnac020.Peer-Reviewed Original Research
2021
Optimizing the Impact of Pragmatic Clinical Trials for Veteran and Military Populations: Lessons From the Pain Management Collaboratory
Ali J, Antonelli M, Bastian L, Becker W, Brandt CA, Burgess DJ, Burns A, Cohen SP, Davis AF, Dearth CL, Dziura J, Edwards R, Erdos J, Farrokhi S, Fritz J, Geda M, George SZ, Goertz C, Goodie J, Hastings SN, Heapy A, Ilfeld BM, Katsovich L, Kerns RD, Kyriakides TC, Lee A, Long CR, Luther SL, Martino S, Matheny ME, McGeary D, Midboe A, Pasquina P, Peduzzi P, Raffanello M, Rhon D, Rosen M, Esposito ER, Scarton D, Hastings SN, Seal K, Silliker N, Taylor S, Taylor SL, Tsui M, Wright FS, Zeliadt S. Optimizing the Impact of Pragmatic Clinical Trials for Veteran and Military Populations: Lessons From the Pain Management Collaboratory. Military Medicine 2021, 187: 179-185. PMID: 34791412, PMCID: PMC9389906, DOI: 10.1093/milmed/usab458.Peer-Reviewed Original ResearchConceptsPragmatic clinical trialsPain Management CollaboratoryClinical trialsMultisite pragmatic clinical trialManagement of painDual public health crisesCommon co-occurring conditionsPragmatic trial designUnmet healthcare needsMilitary Health SystemCo-occurring conditionsPublic health crisisPain managementChronic painNonpharmacological approachesOpioid misuseMultifactorial etiologyTrial designVeterans AffairsMilitary populationHealthcare needsHealth systemNational InstitutePainCOVID-19 pandemicAssessing the impact of the COVID-19 pandemic on pragmatic clinical trial participants
Coleman BC, Purcell N, Geda M, Luther SL, Peduzzi P, Kerns RD, Seal KH, Burgess DJ, Rosen MI, Sellinger J, Salsbury SA, Gelman H, Brandt CA, Edwards RR. Assessing the impact of the COVID-19 pandemic on pragmatic clinical trial participants. Contemporary Clinical Trials 2021, 111: 106619. PMID: 34775101, PMCID: PMC8585559, DOI: 10.1016/j.cct.2021.106619.Peer-Reviewed Original ResearchConceptsPain Management CollaboratoryCOVID-19 pandemicCOVID-19 infection statusClinical researchInfection statusPragmatic clinical trialsIntegrated care modelClinical trial participantsMilitary Health SystemFuture public health emergenciesClinical research teamPublic health emergencyPain managementNonpharmacological approachesPragmatic trialClinical trialsCare modelTrial participantsPain researchHealth departmentsThree-point scaleStudy participantsHealth systemHealth emergencyPeriod of quarantineCorrelates 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 medicationsDevelopment and Implementation of the Military Treatment Facility Engagement Committee (MTFEC) to Support Pragmatic Clinical Trials in the Military Health System
Scarton DV, Roddy WT, Taylor JA, Geda M, Brandt CA, Peduzzi P, Kerns RD, Pasquina PF. Development and Implementation of the Military Treatment Facility Engagement Committee (MTFEC) to Support Pragmatic Clinical Trials in the Military Health System. Military Medicine 2021, 186: 70-75. PMID: 33499543, PMCID: PMC7980475, DOI: 10.1093/milmed/usaa368.Peer-Reviewed Original ResearchConceptsPain Management CollaboratoryPragmatic clinical trialsMilitary treatment facilitiesHealth care systemPain managementClinical trialsDOD health care systemVA health care systemCare systemChronic pain managementService membersTraumatic brain injuryMilitary Health SystemMilitary service membersChronic painNonpharmacological approachesBrain injuryLimb lossClinical practiceHealth systemCoordinating CenterTrialsVA programsNational InstituteDepartment of DefensePain, 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
Strategy for addressing research-site overlap in pragmatic clinical trials: lessons learned from the NIH-DOD-VA Pain Management Collaboratory (PMC)
Geda M, George SZ, Burgess DJ, Scarton DV, Roddy WT, Gordon KS, Pasquina PF, Brandt CA, Kerns RD, Peduzzi P. Strategy for addressing research-site overlap in pragmatic clinical trials: lessons learned from the NIH-DOD-VA Pain Management Collaboratory (PMC). Trials 2020, 21: 1021. PMID: 33308289, PMCID: PMC7731473, DOI: 10.1186/s13063-020-04941-8.Peer-Reviewed Original ResearchConceptsPain Management CollaboratoryPragmatic clinical trialsVA Medical CenterMilitary treatment facilitiesClinical trialsExclusion criteriaVeterans AffairsHealth care systemPain managementNonpharmacological approachesPragmatic trialMedical CenterEligibility criteriaTrial settingsTrial integrityCare systemNational InstituteTrialsRecruitment methodsRecruitment strategiesRecruitment planRecruitment sitesDesigning Trials with Purpose: Pragmatic Clinical Trials of Nonpharmacological Approaches for Pain Management
Gordon KS, Peduzzi P, Kerns RD. Designing Trials with Purpose: Pragmatic Clinical Trials of Nonpharmacological Approaches for Pain Management. Pain Medicine 2020, 21: s7-s12. PMID: 33313727, PMCID: PMC7825099, DOI: 10.1093/pm/pnaa347.Peer-Reviewed Original ResearchConceptsPragmatic clinical trialsPatient-centered outcomesPain managementNonpharmacological approachesPRECIS-2 domainsClinical trialsFuture pragmatic clinical trialsImportant patient-centered outcomesPragmatic-Explanatory Continuum Indicator SummaryNonpharmacological pain managementPain care planManagement of painCommon co-occurring conditionsRoutine clinical practiceCo-occurring conditionsDesigning TrialsUsual careCare plansClinical practiceSignificant causeTrialsPainOutcomesFuture investigatorsManagementAdapting to disruption of research during the COVID-19 pandemic while testing nonpharmacological approaches to pain management
Coleman BC, Kean J, Brandt CA, Peduzzi P, Kerns RD, . Adapting to disruption of research during the COVID-19 pandemic while testing nonpharmacological approaches to pain management. Translational Behavioral Medicine 2020, 10: 827-834. PMID: 32885815, PMCID: PMC7499692, DOI: 10.1093/tbm/ibaa074.Peer-Reviewed Original ResearchMeSH KeywordsBetacoronavirusChronic PainCommunicable Disease ControlCoronavirus InfectionsCOVID-19HumansMental HealthNational Institutes of Health (U.S.)Pain ManagementPandemicsPatient SelectionPneumonia, ViralResearchSARS-CoV-2Socioeconomic FactorsUnited StatesUnited States Department of Veterans AffairsConceptsPain Management CollaboratoryPragmatic clinical trialsChronic painCOVID-19 pandemicUrgent public health challengePain management interventionsClinical care teamPatient-reported measuresPublic health challengeVeterans Health SystemCOVID-19Pain managementNonpharmacological approachesStudy protocolClinical trialsCare teamIntervention deliveryHealth departmentsHealth outcomesHealth challengesHealth systemStudy designMental healthDisruption of researchParticipant recruitment
2019
Core Competencies for the Emerging Specialty of Pain Psychology
Wandner LD, Prasad R, Ramezani A, Malcore SA, Kerns RD. Core Competencies for the Emerging Specialty of Pain Psychology. American Psychologist 2019, 74: 432-444. PMID: 30070541, DOI: 10.1037/amp0000330.Peer-Reviewed Original ResearchConceptsNational Pain StrategyPain managementInstitute of MedicinePain psychologistPain strategiesChronic painPain carePain psychologyPainField of psychologyIOM reportCore competenciesSpecialty areasPsychologistsHuman ServicesPivotal rolePsychologyMultiple professionsEmerging SpecialtySpecialtiesCurrent articleManagementCliniciansCare
2018
Project 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 practicesImpact 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 painMixed methods formative evaluation of a collaborative care program to decrease risky opioid prescribing and increase non-pharmacologic approaches to pain management
Becker WC, Mattocks KM, Frank JW, Bair MJ, Jankowski RL, Kerns RD, Painter JT, Fenton BT, Midboe AM, Martino S. Mixed methods formative evaluation of a collaborative care program to decrease risky opioid prescribing and increase non-pharmacologic approaches to pain management. Addictive Behaviors 2018, 86: 138-145. PMID: 29576479, DOI: 10.1016/j.addbeh.2018.03.009.Peer-Reviewed Original ResearchConceptsNon-pharmacologic treatment modalitiesImplementation facilitation strategyPain management providersNon-pharmacologic approachesCollaborative care programPatient-level barriersSemi-structured qualitative phone interviewsClinical pharmacist's roleSystem-level barriersQualitative phone interviewsMixed-methods formative evaluationVeterans Affairs (VA) employeesOpioid prescribingPain managementTreatment modalitiesPharmacist's roleCare programClinical programsChange ScalePhone interviewsOpioidsQualitative themesDescriptive statisticsOrganizational readinessSubsequent rate
2017
Drug Counselor Responses to Patients’ Pain Reports: A Qualitative Investigation of Barriers and Facilitators to Treating Patients with Chronic Pain in Methadone Maintenance Treatment
Beitel M, Oberleitner L, Kahn M, Kerns RD, Liong C, Madden LM, Ginn J, Barry DT. Drug Counselor Responses to Patients’ Pain Reports: A Qualitative Investigation of Barriers and Facilitators to Treating Patients with Chronic Pain in Methadone Maintenance Treatment. Pain Medicine 2017, 18: 2152-2161. PMID: 28177509, DOI: 10.1093/pm/pnw327.Peer-Reviewed Original ResearchConceptsOpioid use disorderMethadone maintenance treatmentChronic painDrug counselorsMaintenance treatmentTreatment needsUse disordersMedical providersCo-occurring chronic painMethadone maintenance treatment programPain management referralsChronic noncancer painPatient-related barriersMethadone-maintained patientsTreatment of patientsMaintenance treatment programPatients' treatment needsNoncancer painMedication regimensPain managementManagement referralsTreatment adherencePatient improvementPatient reportsPain
2016
Improving pain care through implementation of the Stepped Care Model at a multisite community health center
Anderson DR, Zlateva I, Coman EN, Khatri K, Tian T, Kerns RD. Improving pain care through implementation of the Stepped Care Model at a multisite community health center. Journal Of Pain Research 2016, Volume 9: 1021-1029. PMID: 27881926, PMCID: PMC5115680, DOI: 10.2147/jpr.s117885.Peer-Reviewed Original ResearchPrimary care providersPain knowledge scoresCommunity health centersStepped care modelPain careHealth centersCare modelMultisite community health centerFederally Qualified Health CentersOpioid treatment agreementsQualified health centersUrine drug screensDocumentation of painHealth Services frameworkSafety-net practicesElectronic health recordsOpioid prescribingChart reviewPain managementPain outcomesPain treatmentChronic painPain assessmentTreatment agreementsPrimary careIntegrated, Team-Based Chronic Pain Management: Bridges from Theory and Research to High Quality Patient Care
Driscoll MA, Kerns RD. Integrated, Team-Based Chronic Pain Management: Bridges from Theory and Research to High Quality Patient Care. Advances In Experimental Medicine And Biology 2016, 904: 131-147. PMID: 26900068, DOI: 10.1007/978-94-017-7537-3_10.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesicsChronic PainCognitive Behavioral TherapyCombined Modality TherapyComplementary TherapiesCost of IllnessDecision MakingDelivery of Health Care, IntegratedEmpathyGoalsHumansModels, NeurologicalModels, PsychologicalPain ClinicsPain ManagementPatient Care TeamProfessional-Patient RelationsQuality of LifeSocioeconomic FactorsConceptsChronic painSignificant public health concernChronic pain managementInterdisciplinary treatment approachBiopsychosocial modelCost of carePublic health concernHigh-quality patient careQuality patient careMental health professionalsPain managementSocioeconomic burdenPhysical functioningPainTreatment approachesHealth professionalsPatient careOptimal managementHealth concernEmotional distressCareImplementation of telementoring for pain management in Veterans Health Administration: Spatial analysis
Carey EP, Frank JW, Kerns RD, Ho PM, Kirsh SR. Implementation of telementoring for pain management in Veterans Health Administration: Spatial analysis. The Journal Of Rehabilitation Research And Development 2016, 53: 147-156. PMID: 26934696, DOI: 10.1682/jrrd.2014.10.0247.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationProportion of veteransPain managementSCAN-ECHOSpecialty Care Access Network-ExtensionHealth AdministrationPrimary care provider participationPain specialty clinicPrimary care providersSpecialty care clinicsCommunity Healthcare OutcomesLow spatial accessCare clinicsChronic painHealthcare networkPain careGroup of hospitalsSpecialty clinicVHA sitesCare providersVeterans HomeLogistic regressionHealthcare outcomesClinicProvider participationDrug Counselors’ Attitudes Toward Nonpharmacologic Treatments for Chronic Pain
Oberleitner LM, Beitel M, Schottenfeld RS, Kerns RD, Doucette C, Napoleone R, Liong C, Barry DT. Drug Counselors’ Attitudes Toward Nonpharmacologic Treatments for Chronic Pain. Journal Of Addiction Medicine 2016, 10: 34-39. PMID: 26690289, PMCID: PMC4733570, DOI: 10.1097/adm.0000000000000177.Peer-Reviewed Original ResearchConceptsChronic painNonpharmacologic treatmentsDrug counselorsNonpharmacologic pain treatmentsMethadone-maintained patientsInterdisciplinary pain managementMethadone maintenance treatmentVulnerable patient populationCognitive behavioral therapyNonpharmacologic interventionsPain managementPain treatmentPain interventionsMaintenance treatmentPatient populationPainPatientsHerbal medicineGroup interventionEfficacyInterventionTreatmentPerceived EfficacyTherapyUndertreatment