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FORUM - Translating research into quality health care for Veterans


In This Issue

Director's Letter

Director's Letter
by David Atkins, MD, MPH, Director, HSR&D

Commentary

Chronification of Pain and the Science of Pain Management
by Rollin M. Gallagher, MD, MPH, National Director for Pain Management, Veterans Health Administration

The importance of pain research in VHA has never been higher. Defining pain as a public health problem invites an understanding of its phenomenology and an examination of opportunities for HSR&D research...

Response to Commentary

Meeting the Challenge of Chronic Pain as a Public Health Problem
by Erin E. Krebs, MD, MPH, HSR&D Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota and Robert D. Kerns, PhD, HSR&D Pain Research, Informatics, Multi-morbidities and Education (PRIME) Center, West Haven, Connecticut

Given its immense public health burden, our approach to chronic pain must extend beyond interventions focused solely on symptom alleviation. At both population and individual levels, prevention of chronic pain disability is a critical target for interventions....

Research Highlights

Opioids and Dual Healthcare System Use
by Walid F. Gellad, MD, MPH, HSR&D Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania

While VA has adopted several strategies to mitigate the risks of opioid medications, these efforts focus almost entirely on monitoring prescriptions dispensed within VA. However, without understanding non-VA use, VA will be unable to develop fully successful interventions to address opioid safety...


Opioid Safety and Challenges Related to Expanded Access
by William C. Becker, MD, Brenda T. Fenton, PhD, and Robert D. Kerns, PhD, HSR&D Pain Research, Informatics, Multi-morbidities & Education (PRIME) Center of Innovation, West Haven, Connecticut

We hypothesize that the Veterans Access, Choice and Accountability Act will increase participants' risk of unsafe opioid therapy and so have assembled a multi-disciplinary team of clinical researchers and operations partners to improve methods of measuring outside-of-VHA controlled substance receipt...


A VA Priority: Complementary and Integrative Health Approaches to Addressing Pain
by Stephanie L. Taylor, PhD, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Los Angeles Healthcare System, Los Angeles, California, and Karl Lorenz, MD, MSHS, HSR&D Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, California

Complementary and integrative health (CIH) holds promise as a Veteran-centered approach to improving pain. VA has an opportunity to strengthen the evidence base for CIH as a pain intervention, and understand how CIH impacts pain, the patient-centeredness of the care experience, and provider experiences and approaches, including opioid use...



Treatments for Veterans with Chronic Low Back Pain: The CAMEO Trial
by Matthew J. Bair, MD, MS, HSR&D Center for Health Information and Communication, Indianapolis, Indiana

Our research team designed the CAre Management for the Effective use of Opioids (CAMEO) Trial to compare the effectiveness of pharmacological versus non-pharmacological approaches for primary care patients with chronic low back pain...






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