March 30, 2018: HHS-DoD-VA Pain Management Collaboratory


Robert D. Kerns, PhD
Professor of Psychiatry, Neurology, and Psychology
Yale University


HHS-DoD-VA Pain Management Collaboratory


Pragmatic clinical trials; Clinical research; Health and Human Services; Veterans Affairs, Department of Defense; Pain research

Key Points

  • Nearly one-third of the U.S. adult population reports chronic pain, and treating it costs the healthcare system nearly $500 billion per year.
  • Military service members and veterans are particularly vulnerable subgroups, with anywhere from 50%-75% of veterans experiencing persistent pain.
  • Guidelines from the Centers for Disease Control and Prevention (CDC) advise that opioids not be used in first-line or routine treatment for chronic pain.
  • The primary goal of the Health and Human Services-Department of Defense-Veterans Affairs (HHS-DoD-VA) Pain Management Collaboratory is to conduct pragmatic trials evaluating non-pharmacologic approaches to pain management in military and veteran healthcare organizations.

Discussion Themes

The VA healthcare system has the advantage of 20 years of data for pain intensity ratings that have been collected in routine care—the one exception being a measure of functioning.

What are the considerations for potential privatization of the VA and ensuring the same level of access to data?

Ideally the Pain Management Collaboratory initiative would provide leverage for researchers to promote improved access to electronic health record (EHR) data for researchers.

There is a lot of competition for the same participants within the area of military and veteran healthcare, which is a consideration for the Pain Collaboratory when moving from planning to implementation.


The PPACT Demonstration Project of the NIH Collaboratory is a pragmatic trial addressing chronic pain in primary care. Read more at The Living Textbook


@PCORI, @PCTGrandRounds, @Yale, @HHSGov, @DeptofDefense, @DeptVetAffairs, #chronicpain, #collaborativecare, #pragmatictrials, #healthsystems, #qualityoflife, #pctGR

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