Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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2008 — Implementing Multimodal Pain Care for Veterans in a Time of Rapidly Changing Evidence and Policy

Lead/Presenter: William Becker
All Authors: Frank JW (VA Eastern Colorado Health Care System, Denver, CO) Heapy AA (VA Connecticut Healthcare System, West Haven, CT) Sandbrink F (Washington DC VA Medical Center, Washington, DC)

Brief description of panelists:
Alicia Heapy, PhD is a clinical health psychologist and researcher at the VA Connecticut Healthcare System and project PI in the IMPROVE QUERI. Joseph Frank, MD, MPH is a general internist and researcher at the VA Eastern Colorado Health Care System and project PI in the Triple Aim QUERI. Friedhelm Sandbrink, MD is the acting director of the VA National Pain Management Program and a key operational partner for the IMPROVE QUERI, the Triple Aim QUERI and the Measurement Science QUERI, which together support five distinct pain-focused projects.

Description of the question or issue that will be discussed:
This partnered panel workshop will provide an overview of the policy environment in which the Department of Veterans Affairs (VA) and its National Pain Management Program are working to improve the safety and effectiveness of chronic pain care for Veterans. Specific operational priorities discussed will include the VA's Opioid Safety Initiative, recent opioid guidelines from the VA/DoD and CDC, the 2016 Comprehensive Addiction and Recovery Act, and the MyVA Access initiative. We will present findings from five ongoing QUERI-funded evaluations of distinct models of pain care. These models represent the breadth of VA pain care and are both Veteran focused (Pharmacist support, Integrated pain team, Interactive voice response) and provider focused (Telementoring, Academic Detailing). Panelists will participate in a moderated discussion of current and future operational and research priorities, identifying key unanswered questions that must be addressed to guide VA policy on pain management.

Significance—Description of why the issue is important for Veterans, VA, and the audience:
Chronic pain affects half of Veterans using the VA. In 2013, nearly 900,000 Veterans received an opioid medication despite inadequate evidence of long-term benefit and growing evidence of harms. Since 2009, the VA has pursued a stepped care model of pain management, a population-based strategy in which the majority of pain care is delivered in primary care with specialty pain care directed toward more complex, higher risk patients. Since then, multiple national initiatives have been implemented to promote access to safe, effective pain care. In this context, it is critical to develop new models of care to support primary care providers' efforts, prevent provider burn out, and provide patients with evidence-based, accessible pain care.