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. 2016 Aug;157(8):1696-1703.
doi: 10.1097/j.pain.0000000000000567.

The musculoskeletal diagnosis cohort: examining pain and pain care among veterans

Joseph L Goulet  1 , Robert D Kerns  1 , Matthew Bair  2 , William C Becker  1 , Penny Brennan  3 , Diana J Burgess  4 , Constance M Carroll  1 , Steven Dobscha  5 , Mary A Driscoll  1 , Brenda T Fenton  1 , Liana Fraenkel  1 , Sally G Haskell  1 , Alicia A Heapy  1 , Diana M Higgins  6 , Rani A Hoff  1 , Ula Hwang  7 , Amy C Justice  1 , John D Piette  8 , Patsi Sinnott  9 , Laura Wandner  1 , Julie A Womack  1 , Cynthia A Brandt  1
Affiliations

The musculoskeletal diagnosis cohort: examining pain and pain care among veterans

Joseph L Goulet et al. Pain. 2016 Aug.

Abstract

Musculoskeletal disorders (MSDs) are highly prevalent, painful, and costly disorders. The MSD Cohort was created 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. We searched electronic health records to identify patients treated in Veterans Health Administration who had ICD-9-CM codes for diagnoses including, but not limited to, joint, back, and neck disorders, and osteoarthritis. Cohort inclusion criteria were 2 or more outpatient visits occurring within 18 months of one another or one inpatient visit with an MSD diagnosis between 2000 and 2011. The first diagnosis is the index date. Pain intensity numeric rating scale (NRS) scores, comorbid medical and mental health diagnoses, pain-related treatments, and other characteristics were collected retrospectively and prospectively. The cohort included 5,237,763 patients; their mean age was 59, 6% were women, 15% identified as black, and 18% reported severe pain (NRS ≥ 7) on the index date. Nontraumatic joint disorder (27%), back disorder (25%), and osteoarthritis (21%) were the most common MSD diagnoses. Patients entering the cohort in recent years had more concurrent MSD diagnoses and higher NRS scores. The MSD Cohort is a rich resource for collaborative pain-relevant health service research.

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Conflict of interest statement

Conflicts of interest: The authors declare that they have no conflicting interests.

Figures

Figure 1
Figure 1
Proportion of women veterans entering the MSD cohort in each age group, by year of cohort entry. Each bar represents the proportion of women veterans in each age group entering the cohort in that year
Figure 2
Figure 2
Distribution of pain intensity NRS scores on the MSD index date, by MSD diagnosis.* OA=osteoarthritis; RA=rheumatoid arthritis; SCI=spinal cord injury; TMD=temporomandibular disorder *The circles represent the mean NRS score on the MSD index date for veterans with each diagnosis, the asterisk the median, and the ends of the whiskers represent the 25th percentile (bottom horizontal bar) and the 75th percentile
Figure 3
Figure 3
Patients with depressive disorder diagnoses, by MSD disorder and level of reported pain intensity. Larger bars represent number of patients with each MSD, by level of pain. Smaller bars within represent those with depressive disorders.
See this image and copyright information in PMC

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