BALTIMORE — Bipolar veterans with chronic pain sometimes have problems receiving evidence-based treatment in the VA healthcare system, according to a new study.
Researchers from the VA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC) at the VA Maryland Health Care System in Baltimore and colleagues pointed out that those patients face “unique barriers that compromise equitable access to evidence-based pain treatment.”
Their small study, with results published in Health Services Research, involved 15 veterans with chronic pain and bipolar disorder and 15 providers working within a mid-Atlantic VA healthcare system. Data were collected from August 2017-June 2018.1
The researchers interviewed veterans about their chronic pain experiences and treatment, including barriers that arose when trying to access pain management services. Interviews with providers asked whether they address chronic pain with veteran patients and, if so, what considerations arise when addressing pain in veterans with bipolar disorder and other serious mental illnesses.
All veteran participants were at least 18 years old, had a confirmed bipolar disorder and chronic pain diagnosis, and engaged in outpatient care within the VA healthcare system. Clinicians provided direct care services to veterans within the same VA. Interviews lasted approximately 60 minutes and were transcribed and analyzed using a rapid analysis protocol.
The study advised that four major themes emerged from veteran and provider interviews:
- siloed care (unintegrated and uncoordinated mental and physical healthcare),
- mental health primacy (prioritization of mental health symptoms at expense of physical health symptoms),
- lagging expectations (unfamiliarity with comprehensive evidence-based pain management options), and
- provider-patient communication concerns (inefficient communication about pain concerns and treatment options).
“Our findings suggest that educating providers about bipolar disorder and other serious mental illnesses and the benefit of effective non-pharmacological pain interventions for this group may improve care coordination and care quality and reduce access disparities,” the researchers concluded.
- Travaglini LE, Bennett M, Kacmarek CN, Kuykendall L, Coakley G, Lucksted A. Barriers to accessing pain management services among veterans with bipolar disorder. Health Serv Res. 2023 Sep 4. doi: 10.1111/1475-6773.14221. Epub ahead of print. PMID: 37667502.