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Comorbid Chronic Pain and Posttraumatic Stress Disorder Among Veterans: Approaches to Care
Journal article   Open access   Peer reviewed

Comorbid Chronic Pain and Posttraumatic Stress Disorder Among Veterans: Approaches to Care

Alessandra A Pratt, Jennifer Van Tiem, Brian C Lund, Nicole L Johnson, Kenda R S Steffensmeier, Daniel D Ball, Emily B K Thomas, Michelle A Mengeling, Sonya B Norman, Mary A Driscoll, …
Military medicine, Vol.190(9-10), pp.e2058-e2064
09/01/2025
DOI: 10.1093/milmed/usaf118
PMCID: PMC12596722
PMID: 40215123
url
https://doi.org/10.1093/milmed/usaf118View
Published (Version of record) Open Access

Abstract

The aim is to elucidate approaches to care for comorbid chronic pain and PTSD (CP + PTSD) in the Veterans Administration (VA). These conditions are co-magnifying and highly comorbid but traditionally treated in separate clinical settings. This multimethod analysis examined care for CP + PTSD via administrative data analyses and qualitative interviews of VA-served veterans. All participants with diagnoses of CP + PTSD in 2021 were identified using VA administrative data (N = 456,544). Visits during the following year (2022) coded for chronic pain, PTSD, or both were analyzed. Qualitative interview participants (N = 22) were recruited, screened, consented, and enrolled in 2023. Administrative findings demonstrated that clinical settings differed where CP and PTSD were treated. For PTSD, 90.7% of visits occurred in the mental health service line, whereas for CP, visits occurred across a range of settings outside mental health (e.g., primary care, rehabilitative services, and surgical services). A small percentage of visits (4.8%) were coded for both CP + PTSD, indicating possible combined care. In qualitative interviews, participants acknowledged that CP and PTSD symptoms may impact one another but noted that the health care they received for these 2 conditions was typically siloed. Participants also identified barriers that would need to be addressed before a fully integrated coordinated care model could be implemented. Veterans reported interest in coordinated treatment for CP + PTSD; however, the provision of CP + PTSD care provided across different service lines may pose challenges to optimizing care coordination.
Comorbidity Veterans Chronic Pain Data Analysis post-traumatic stress disorder UIOWA OA Agreement

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