This is a curated list of comprehensive codes identifying targeted non-IV administered opioid medications. Recommendations specify how Electronic Health Record (EHR) medication records for a targeted cohort can be searched to identify all filled prescriptions.
The Musculoskeletal Disorders MSD Cohort was created in 2016 to characterize variation in pain, comorbidities, treatment, and outcomes among patients with MSD receiving Veterans Health Administration care across demographic groups, geographic regions, and facilities. The MSD cohort phenotypes pain populations for collaborative pain-relevant epidemiological and health service research. The MSD/General Pain (Goulet et. al codes) were cross walked from ICD-9 to ICD-10.
Healthcare Utilization recommendations provide for calculating summary counts of both inpatient and outpatient healthcare utilization. VA clinics that provide outpatients services (Primary Care, Emergency Medicine, Telehealth, etc.) are identified using list of identification are identified in the EHR unique codes (Stop Codes).
High Impact Chronic Pain (HICP) is defined as the presence of pain on at least half of days in the previous 3-6 months with substantial restriction of functional participation in work, social, and self-care activities. HICP is assessed with several questions assessing the duration, frequency, and impact of chronic pain, as well as one question regarding the impact of pain on work. In the PMC3, those who report pain on most days for the past 3 months, and who report that pain limits their life or work activities, are considered to have HICP.
We compared operational definitions (ICD9/10) that targeted a non-VA research setting (PROUD), a VA research setting (Seal et al., 2019) and non-research quality measurement system, the Healthcare Effectiveness Data and Information Set (HEDIS) and determined that there was overlap across SUD sub-categories of opioid use disorder, alcohol use disorder, other substance used disorders. Based on this review, Primary Care Opioid Use Disorders Treatment Trial (PROUD) was recommended as the phenotype for the PMC-3.
The NSCAP assesses the frequency, targeted outcome (e.g., “to manage pain”), perceived effectiveness, and setting of these approaches.
The 5-item PMC COVID-19 measure assesses five potential domains of pandemic impact: access to healthcare, social support, finances, ability to meet basic needs, and mental or emotional health. Two additional items assess infection status (personal and household) and hospitalization.
In surveys of patients with chronic pain, pain intensity is described as a critically important dimension of the pain experience and a crucial target of pain treatments (Turk et al., 2008). Moreover, panels of pain experts have suggested that “For most clinical trials of chronic pain treatments, a measure of pain intensity will provide the primary outcome measure.”
The International Association for the Study of Pain and ICD diagnoses of chronic pain use a minimum 3-
month threshold for establishing chronicity. For clinical trials
of treatments for chronic pain, IMMPACT recommends a 6-month minimum for pain duration, which we apply for this instrument.
The Patient Health Questionnaire-2 (PHQ-2) is a widely used, patient-reported, 2-item screening measure for depression.