ArticlePain medicine (Malden, Mass.)2020
Pain Care in the Department of Veterans Affairs: Understanding How a Cultural Shift in Pain Care Impacts Provider Decisions and Collaboration.
Article in Pain medicine (Malden, Mass.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
13 citing papers in PubMed, 24 citations in OpenAlex.
- Pain science knowledge among healthcare Professionals: A cross-sectional survey within the United States Department of Veterans Affairs.Musculoskeletal science & practice · 2025Article
- Evaluating spoke facilitation costs of implementing TelePain in the Veterans Health Administration.Implementation science communications · 2025Article
- Exploring Veterans' Experiences Accessing Chronic Pain Treatment in the VA Community Care Network.Journal of general internal medicine · 2024Article
- Implementation, intervention, and downstream costs for implementation of a multidisciplinary complex pain clinic in the Veterans Health Administration.Health services research · 2024Article
- Pain Care Disparities and the Use of Virtual Care Among Racial-Ethnic Minority Groups During COVID-19.Journal of general internal medicine · 2024Article
- Observational
- Mixed-methods formative evaluation of implementing an adapted suicide prevention treatment: Dialectical Behavior Therapy Skills Groups in the Veterans Health Administration.Frontiers in psychiatry · 2024Article
- Behavioral Health, Telemedicine, and Opportunities for Improving Access.Current pain and headache reports · 2022Review
- Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems.Learning health systems · 2022Article
- The acceptability and feasibility of screening, brief intervention, and referral to treatment for pain management among new England veterans with chronic pain: A pilot study.Pain practice : the official journal of World Institute of Pain · 2022Article
- Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.Pain medicine (Malden, Mass.) · 2020Article
- Stakeholder Engagement in Pragmatic Clinical Trials: Emphasizing Relationships to Improve Pain Management Delivery and Outcomes.Pain medicine (Malden, Mass.) · 2020Article
- Misalignment of Stakeholder Incentives in the Opioid Crisis.International journal of environmental research and public health · 2020Review
Corrections and comments
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Authors and funding
11 authors at 9 institutions in 1 country.
Funding
Abstract
objectiveOver the past decade, the Department of Veterans Affairs (VA) has experienced a sizeable shift in its approach to pain. The VA's 2009 Pain Management Directive introduced the Stepped Care Model, which emphasizes an interdisciplinary approach to pain management involving pain referrals and management from primary to specialty care providers. Additionally, the Opioid Safety Initiative and 2017 VA/Department of Defense (DoD) clinical guidelines on opioid prescribing set a new standard for reducing opioid use in the VA. These shifts in pain care have led to new pain management strategies that rely on multidisciplinary teams and nonpharmacologic pain treatments. The goal of this study was to examine how the cultural transformation of pain care has impacted providers, the degree to which VA providers are aware of pain care services at their facilities, and their perceptions of multidisciplinary care and collaboration across VA disciplines.
methodsWe conducted semistructured phone interviews with 39 VA clinicians in primary care, mental health, pharmacy, and physical therapy/rehabilitation at eight Veterans Integrated Service Network medical centers in New England.
resultsWe identified four major themes concerning interdisciplinary pain management approaches: 1) the culture of VA pain care has changed dramatically, with a greater focus on nonpharmacologic approaches to pain, though many "old school" providers continue to prefer medication options; 2) most facilities in this sample have no clear roadmap about which pain treatment pathway to follow, with many providers unaware of what treatment to recommend when; 3) despite multiple options for pain treatment, VA multidisciplinary teams generally work together to ensure that veterans receive coordinated pain care; and 4) veteran preferences for care may not align with existing pain care pathways.
conclusionsThe VA has shifted its practices regarding pain management, with a greater emphasis on nonpharmacologic pain options. The proliferation of nonpharmacologic pain management strategies requires stakeholders to know how to choose among alternative treatments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.