Evidence map›Paper›PMID 37667502›Full record

ArticleHealth services research2023

Barriers to accessing pain management services among veterans with bipolar disorder.

Letitia E Travaglini, Melanie Bennett, Corinne N Kacmarek, Lorrianne Kuykendall, Gabriella Coakley, Alicia Lucksted

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06758414 (Exploring the Efficacy of Cognitive Behavioral Therapy for Chronic Pain in Veterans With Serious Mental Illness), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06758414 narecruitingnot on this mapstarted 2026, after this paper: background citation

Exploring the Efficacy of Cognitive Behavioral Therapy for Chronic Pain in Veterans With Serious Mental Illness

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2026 to 2029Enrolled190ConditionsChronic Pain, Schizophrenia, Psychotic Disorders, Bipolar DisorderArmsCognitive Behavioral Therapy for Chronic Pain (CBT-CP), Health & Wellness (H&W)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Letitia E TravagliniVA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), VA Maryland Health Care System, Baltimore, Maryland, USA.ORCID 0000-0002-6289-8886
Melanie BennettVA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), VA Maryland Health Care System, Baltimore, Maryland, USA.
Corinne N KacmarekVA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), VA Maryland Health Care System, Baltimore, Maryland, USA.
Lorrianne KuykendallOffice of Research and Development, Washington DC VA Medical Center, Washington, DC, USA.
Gabriella CoakleyVA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), VA Maryland Health Care System, Baltimore, Maryland, USA.
Alicia LuckstedVA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), VA Maryland Health Care System, Baltimore, Maryland, USA.
University of Maryland, Baltimore · USLoyola University Maryland · USVA Capitol Health Care Network · USWashington DC VA Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo identify barriers veterans with bipolar disorder face to accessing chronic pain management services within a Veterans Affairs (VA) health care system. DATA SOURCES AND STUDY

settingVeterans (n = 15) with chronic pain and bipolar disorder and providers (n = 15) working within a mid-Atlantic VA health care system. Data were collected from August 2017-June 2018. STUDY

designVeteran interviews focused on their chronic pain experiences and treatment, including barriers that arose when trying to access pain management services. Provider interviews focused on whether they address chronic pain with veteran patients and, if so, what considerations arise when addressing pain in veterans with bipolar disorder and other serious mental illnesses. DATA COLLECTION: Veterans were at least 18 years old, had a confirmed bipolar disorder and chronic pain diagnosis, and engaged in outpatient care within the VA health care system. Clinicians provided direct care services to veterans within the same VA. Interviews lasted approximately 60 min and were transcribed and analyzed using a rapid analysis protocol. PRINCIPAL

findingsFour major themes emerged from veteran and provider interviews: siloed care (unintegrated and uncoordinated mental and physical health care), mental health primacy (prioritization of mental health symptoms at expense of physical health symptoms), lagging expectations (unfamiliarity with comprehensive evidence-based pain management options), and provider-patient communication concerns (inefficient communication about pain concerns and treatment options).

conclusionsVeterans with co-occurring pain and bipolar disorder face unique barriers that compromise equitable access to evidence-based pain treatment. Our findings suggest that educating providers about bipolar disorder and other serious mental illnesses and the benefit of effective non-pharmacological pain interventions for this group may improve care coordination and care quality and reduce access disparities.

Indexed as

Bipolar DisorderChronic PainVeteransAdolescentHealth Services AccessibilityHumansPain ManagementQualitative ResearchUnited StatesUnited States Department of Veterans Affairsaccess/demand/utilization of serviceschronic diseasemental healthqualitative researchVA health care system

Identifiers

PMID37667502
PMCPMC10622259
OpenAlexW4386437900

What OpenQuestion holds

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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.