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VA RESEARCH QUARTERLY UPDATE
This Issue: The Aging Veteran | Table of Contents: Summer 2016 |

Noteworthy Publications

Study focuses on course of pain in older Veterans


Researchers with VA and Oregon Health and Science University tracked pain outcomes in nearly 13,000 VA patients aged 65 or older. (<em>Photo: ©iStock/janulla)</em>
Researchers with VA and Oregon Health and Science University tracked pain outcomes in nearly 13,000 VA patients aged 65 or older. (Photo: ©iStock/janulla)

Researchers with VA and Oregon Health and Science University tracked pain outcomes in nearly 13,000 VA patients aged 65 or older. (Photo: ©iStock/janulla)

Older Veterans with chronic pain frequently show improvements in the intensity of their pain over time. However, prescriptions of opioids, mental health issues, and certain pain diagnoses are associated with a lower likelihood of improvement, according to a study appearing in the July 2016 issue of the Journal of Pain.

The study, by researchers with the VA Portland Health Care System and Oregon Health and Science University, looked at the medical records of nearly 13,000 Veterans aged 65 or older receiving VA care.

Each of these Veterans had rated their pain as "moderate" or "severe" (scores of four or more on an 11-point scale) on VA's numeric rating scale for pain within the 12 months before the study, and none had been prescribed opioids at the beginning of the study.

Most of the Veterans in the study were male. Their average age was 74, and nearly half had service-connected disabilities.

The team found that, on average, the intensity of these Veterans' pain decreased between 25 and 29 percent over a three-month period—and nearly two-thirds of the Veterans reported that their pain had been reduced by more than 30 percent.

Veterans who had higher scores at the beginning of the study tended to report the highest decreases in pain intensity, as did those who were among the older study participants. Those least likely to see significant decreases in pain, as mentioned above, included those who had mental health issues, those who had high levels of service-connected disability, and those who began using opioids for pain during the 12-month study period.

In a 2015 presentation on the study, lead author Dr. Stephen K. Dobscha noted, however, that "we need to be careful about not assuming causal relationships. People who receive opioid medication prescriptions may have worse pain conditions or worse prognosis [to begin with].

"We cannot assume that the opioid medication causes them to do more poorly over time," he continued. "It is actually possible that opioid medications might have prevented them from doing even worse."

Race and ethnicity, the researchers found, were not associated with improvements of pain scores over time. Nor were substance use disorders and nicotine addiction.


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