Ajay Manhapra, MBBS
About
Research
Publications
2024
The Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury
Kennedy E, Manhapra A, Miles S, Martindale S, Rowland J, Mobasher H, Myers M, Panahi S, Walker W, Pugh M. The Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury. Journal Of Neurotrauma 2024 PMID: 38907690, DOI: 10.1089/neu.2024.0126.Peer-Reviewed Original ResearchPredictors of pain interferencePain interferenceMild traumatic brain injuryTraumatic brain injuryU.S. service membersPain intensityAssociated with pain interferenceAssociated with functional limitationsService membersRates of traumatic brain injuryPain interference scoresPain intensity scoresHistory of traumatic brain injuryProspective longitudinal observational studyNon-pain symptomsTraumatic brain injury historyLongitudinal observational studyHolistic treatment approachSymptoms of mild traumatic brain injuryBrain injuryFunctional limitationsPain scoresChronic painIdentifying fatigueTargeting comorbidities
2023
Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing
Manhapra A, MacLean R, Rosenheck R, Becker W. Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing. British Journal Of Clinical Pharmacology 2023 PMID: 37990580, DOI: 10.1111/bcp.15972.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyFunctional gainsChronic pain syndromeMaximum functional recoveryOngoing opioid crisisParadoxical worseningAnalgesic benefitAnalgesic therapyPain reliefPain syndromeEffective analgesicMost patientsAntinociceptive effectAntinociceptive systemChronic painFunctional recoveryOpioid actionOpioid dependenceMedical instabilityFunctional improvementPlacebo effectClinical principlesOpioid crisisTherapeutic inductionIs psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders?
Manhapra A, Zhou B, Rhee T, Rosenheck R. Is psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders? Journal Of Affective Disorders 2023, 344: 585-591. PMID: 37863364, DOI: 10.1016/j.jad.2023.10.094.Peer-Reviewed Original ResearchConceptsLifetime psychiatric disordersPast-year psychiatric disordersSevere pain interferencePain interferencePsychiatric disordersPD remissionChronic painNon-substance use psychiatric disordersPrevalence of painMental functioningLower physical functioningNational Epidemiologic SurveyRelated Conditions-IIIPoor mental functioningCommon comorbiditiesPhysical functionAdjusted oddsPhysical functioningObservational studyReduced prevalenceRemissionUS adultsDiagnostic remissionEpidemiologic SurveyPainMonotonic Association of Increasing Past-Year Substance Use Disorder across a Four-Level Trauma Post-Traumatic Stress Disorder (PTSD) Hierarchy in a Nationwide Sample
Jegede O, Manhapra A, Zhou B, Rhee T, Rosenheck R. Monotonic Association of Increasing Past-Year Substance Use Disorder across a Four-Level Trauma Post-Traumatic Stress Disorder (PTSD) Hierarchy in a Nationwide Sample. Journal Of Dual Diagnosis 2023, 19: 231-239. PMID: 37796996, DOI: 10.1080/15504263.2023.2260339.Peer-Reviewed Original ResearchConceptsSubstance use disordersTrauma exposureCurrent PTSDUse disordersComparison of adultPast-year substance use disorderSUD prevalencePTSDRelated Conditions Wave IIINational Epidemiologic SurveyTrauma groupNationwide sampleDifferential effectsGreater likelihoodSUD diagnosisUnadjusted resultsClinical consequencesHierarchical groupsEpidemiologic SurveyWave IIIAdultsDisordersMonotonic associationPrior groupPrevalenceBuprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration
Gordon A, Saxon A, Kertesz S, Wyse J, Manhapra A, Lin L, Chen W, Hansen J, Pinnell D, Huynh T, Baylis J, Cunningham F, Ghitza U, Bart G, Yu H, Sauer B. Buprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration. Drug And Alcohol Dependence 2023, 248: 109902. PMID: 37196572, PMCID: PMC10875624, DOI: 10.1016/j.drugalcdep.2023.109902.Peer-Reviewed Original ResearchConceptsOpioid use disorderVeterans Health AdministrationUse disordersHealth AdministrationOpioid use disorder treatmentHalf of patientsOpen cohort studyRetention of patientsCourse of careUse disorder treatmentLarge healthcare systemCohort studyMedian durationPatient characteristicsPatient demographicsDaily doseMedication treatmentBuprenorphine useClinical dataWhite racePatientsProportion daysDisorder treatmentMultiple coursesHealthcare systemPain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates
Manhapra A, Fortinsky R, Berg K, Ross J, Rhee T. Pain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates. The Journals Of Gerontology Series A 2023, 78: 1627-1640. PMID: 37096328, PMCID: PMC10460550, DOI: 10.1093/gerona/glad115.Peer-Reviewed Original ResearchConceptsHigh-impact chronic painChronic painPain managementOlder adultsCoronavirus diseasePain treatmentNational Health Interview SurveyNonpharmacological pain treatmentsUtilization of opioidsHealth Interview SurveyUS older adultsFirst yearOpioid useNonpharmacological treatmentsNonpharmacological interventionsTreatment utilizationLong-term effectsPainU.S. adultsPrevalenceInterview SurveyDiseaseAdultsCOVID-19 pandemicTreatmentRethinking clinically significant pain: a marker of recovery rather than a warning of injury
Manhapra A. Rethinking clinically significant pain: a marker of recovery rather than a warning of injury. Pain 2023, 164: e174-e174. PMID: 36779559, DOI: 10.1097/j.pain.0000000000002800.Peer-Reviewed Original Research
2022
Complex Persistent Opioid Dependence—an Opioid-induced Chronic Pain Syndrome
Manhapra A. Complex Persistent Opioid Dependence—an Opioid-induced Chronic Pain Syndrome. Current Treatment Options In Oncology 2022, 23: 921-935. PMID: 35435616, DOI: 10.1007/s11864-022-00985-x.Peer-Reviewed Original ResearchConceptsChronic pain syndromeOpioid dependenceOpioid taperingPain syndromeClinical conundrumLong-term opioid useWorse pain controlNon-cancer painOpioid use disorderPoor patient acceptanceSeparate clinical entityAnti-reward systemsOpioid doseOpioid therapyPain providersPain controlOpioid usePain mechanismsClinical entityMore painIatrogenic problemsPatient acceptanceTreatment choiceChronic cancerPain experiencePersistence of significant pain interference following substance use disorder remission: Negative association with psychosocial and physical recovery
Manhapra A, Stefanovics EA, Rhee TG, Rosenheck RA. Persistence of significant pain interference following substance use disorder remission: Negative association with psychosocial and physical recovery. Drug And Alcohol Dependence 2022, 232: 109339. PMID: 35121202, DOI: 10.1016/j.drugalcdep.2022.109339.Peer-Reviewed Original ResearchConceptsSubstance use disordersPast-year substance use disorderSevere pain interferencePain interferenceIndependent associationSUD remissionActive substance use disorderSignificant pain interferenceIndependent negative associationRelated Conditions Wave IIINegative associationPositive independent associationStrong negative associationUnited States adultsNational Epidemiologic SurveyPersistent painPhysical functionRemissionUS adultsUse disordersDisorder remissionEpidemiologic SurveyWave IIIClinical attentionStates adults
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